Orthopaedic knee cone components for use in an orthopaedic surgical procedure and instruments and methods for installing the same

ABSTRACT

An orthopaedic joint replacement system is shown and described. The system includes a number of prosthetic components configured to be implanted into a patient&#39;s knee. The system also includes a number of surgical instruments configured for use in preparing the bones of the patient&#39;s knee to receive the implants. A number of methods for using the surgical instruments to prepare the bones is also disclosed.

This continuation-in-part application claims priority to each of U.S.patent application Ser. No. 17/557,620 entitled “MODULAR TIBIAL CONEAUGMENTS AND METHOD OF SURGICALLY USING THE SAME;” U.S. patentapplication Ser. No. 17/557,629 entitled “METHOD OF INSTALLING A KNEECONE AUGMENT IN AN ORTHOPAEDIC SURGICAL PROCEDURE;” and U.S. patentapplication Ser. No. 17/557,635 entitled “KNEE CONE AUGMENTS ANDASSOCIATED SURGICAL BROACHES FOR USE IN AN ORTHOPAEDIC SURGICALPROCEDURE;” each of which was filed on Dec. 21, 2021, each of which isassigned to the same assignee as the present application, and each ofwhich is hereby incorporated by reference.

CROSS-REFERENCE TO RELATED APPLICATIONS

Cross reference is made to U.S. patent application Ser. No. XX/XXX,XXX(Attorney Docket No. 265280-352876/DEP7026USCIP2) entitled “ORTHOPAEDICSURGICAL SYSTEM FOR INSTALLING A KNEE CONE AUGMENT AND METHOD OF USINGTHE SAME;” and U.S. patent application Ser. No. XX/XXX,XXX (AttorneyDocket No. 265280-352877/DEP7026USCIP3) entitled “TRIAL EXTRACTOR OF ANORTHOPAEDIC SURGICAL SYSTEM AND METHOD OF USING THE SAME;” each of whichis assigned to the same assignee as the present application, each ofwhich is filed concurrently herewith, and each of which is herebyincorporated by reference.

TECHNICAL FIELD

The present disclosure relates generally to an orthopaedic system,including prosthetic components, surgical instruments, and methods foruse in the performance of an orthopaedic joint replacement procedure,and more particularly to orthopaedic prosthetic components, surgicalinstruments, and methods for use in the performance of a kneereplacement procedure.

BACKGROUND

Joint arthroplasty is a well-known surgical procedure by which adiseased and/or damaged natural joint is replaced by a prosthetic joint.For example, in a knee arthroplasty surgical procedure, a patient'snatural knee joint is partially or totally replaced by a prosthetic kneejoint or knee prosthesis. A typical knee prosthesis includes a tibialtray, a femoral component, and a polymer insert or bearing positionedbetween the tibial tray and the femoral component. The tibial traygenerally includes a plate having a stem extending distally therefrom,and the femoral component generally includes a pair of spaced apartcondylar elements, which include surfaces that articulate withcorresponding surfaces of the polymer bearing. The stem of the tibialtray is configured to be implanted in a surgically-preparedintramedullary canal of the patient's tibia, and the femoral componentis configured to be coupled to a surgically-prepared distal end of apatient's femur

From time-to-time, a revision knee surgery may need to be performed on apatient. In such a revision knee surgery, the previously-implanted kneeprosthesis, commonly referred to a “primary knee prosthesis,” issurgically removed and a replacement or “revision knee prosthesis” isimplanted. In some revision knee surgeries, all of the components of theprimary knee prosthesis, including, for example, the tibial tray, thefemoral component, and the polymer bearing, may be surgically removedand replaced with revision prosthetic components.

During a revision knee surgery, the orthopaedic surgeon typically uses avariety of different orthopaedic surgical instruments such as, forexample, cutting blocks, surgical reamers, drill guides, prosthetictrials, and other surgical instruments to prepare the patient's bones toreceive the knee prosthesis. Other orthopaedic surgical instruments suchas trial components may be used to size and select the components of theknee prosthesis that will replace the patient's natural joint. Trialcomponents may include a femoral trial that may be used to size andselect a prosthetic femoral component, a tibial tray trial that may beused to size and select a prosthetic tibial tray, and a stem trialcomponent that may be used to size and select a prosthetic stemcomponent.

Moreover, during a revision knee surgery, the orthopaedic surgeon mayuse an augment in combination with the revision tibial tray and/or therevision femoral component to compensate for bone loss associated withremoval of the primary knee prosthesis or other defects in the patient'stibia and/or femur. There are two types of commonly used kneeaugments—sleeve augments and cone augments. A sleeve augment ismechanically locked to one or more of the components of the revisionknee prosthesis prior to implantation of the prosthesis into thepatient's bone. For example, a tibial sleeve augment is mechanicallylocked (e.g., via a taper lock or fastener) to the tibial stem componentand/or the tibial tray prior to implantation of the tibial revisionprosthesis into the tibia of the patient, whereas a femoral sleeveaugment is mechanically locked (e.g., via a taper lock or fastener) tothe femoral stem component and/or the femoral component prior toimplantation of the femoral revision prosthesis into the femoral of thepatient. Cone augments, on the other hand, are not directly locked tothe revision knee prosthesis prior to implantation of the prosthesis inthe bone of the patient. Instead, a cone augment is first separatelyimplanted into the bone of the patient. Thereafter, the revision kneeprosthesis is then implanted into the bone of the patient through theimplanted cone augment. Then, the implanted revision knee prosthesis maybe secured to the previously-implanted cone augment by use of, forexample, bone cement. In the case of a press-fit “cementless” revisionknee prosthesis, the implanted prosthesis is not cemented or otherwisesecured to the previously-implanted cone augment. For example, a tibialcone augment is first separately implanted in the tibia of a patient,with a tibial revision prosthesis then being implanted such that itstibial stem component extends through the tibial cone augment.Subsequent to implantation of the tibial revision prosthesis, bonecement may be used to secure the tibial stem component and the tibialtray to the tibial cone augment (although use of bone cement may beomitted in the case of use of a cementless tibial revision prosthesis).Similarly, in the case of a femoral procedure, a femoral cone augment isfirst separately implanted in the femur of a patient, with a femoralrevision prosthesis then being implanted such that its femoral stemcomponent extends through the femoral cone augment. Subsequent toimplantation of the femoral revision prosthesis, bone cement may be usedto secure the femoral stem component and the femoral component to thefemoral cone augment (although use of bone cement may be omitted in thecase of use of a cementless femoral revision prosthesis).

SUMMARY

An orthopaedic joint replacement system is shown and described. Thesystem includes a number of prosthetic components configured to beimplanted into a patient's knee. The system also includes a number ofsurgical instruments configured for use in preparing the bones of thepatient's knee to receive the implants. Methods or techniques for usingthe surgical instruments to prepare the patient's bones are alsodisclosed.

According to one aspect of the disclosure, a method of surgicallypreparing a proximal end of a tibia of a patient includes reaming anintramedullary canal of the tibia with a canal reamer. The method alsoincludes attaching a proximal end of a stem trial component to a distalend of a surgical broach, and thereafter advancing a distal end of thestem trial component within the reamed intramedullary canal of thetibia. The method also includes broaching the proximal end of the tibiausing the surgical broach secured to the stem trial component duringadvancement of the distal end of the stem trial component within thereamed intramedullary canal of the tibia so as to form asurgically-prepared broached cavity in the proximal end of the tibia. Atibial cone augment is then installed in the broached cavity formed inthe proximal end of the tibia.

In an embodiment, the proximal end of the tibia may be reamed using acone reamer secured to the stem trial component so as to form asurgically-prepared reamed cavity in the proximal end of the tibia priorto broaching the proximal end of the tibia. In such an embodiment, thesurgical broach is advanced into the reamed cavity formed in theproximal end of the tibia during advancement of the distal end of thestem trial component within the reamed intramedullary canal of the tibiaso as to form the surgically-prepared broached cavity in the proximalend of the tibia.

In an embodiment, the stem trial component guides advancement of thesurgical broach during broaching of the proximal end of the tibia.

The canal reamer is removed from the intramedullary canal prior toadvancement of the distal end of the stem trial component within thereamed intramedullary canal.

The method also includes removing a previously-installed tibial implantfrom the tibia of the patient prior to reaming the intramedullary canalof the tibia with the canal reamer.

According to another aspect of the disclosure, a method of surgicallypreparing a distal end of a femur of a patient includes reaming anintramedullary canal of the femur with a canal reamer. The method alsoincludes attaching a proximal end of a stem trial component to a distalend of a surgical broach, and thereafter advancing a distal end of thestem trial component within the reamed intramedullary canal of thefemur. The method also includes broaching the distal end of the femurusing the surgical broach secured to the stem trial component duringadvancement of the distal end of the stem trial component within thereamed intramedullary canal of the femur so as to form asurgically-prepared broached cavity in the distal end of the femur. Afemoral cone augment is then installed in the broached cavity formed inthe distal end of the femur.

In an embodiment, the distal end of the femur may be reamed using a conereamer secured to the stem trial component so as to form asurgically-prepared reamed cavity in the distal end of the femur priorto broaching the distal end of the femur. In such an embodiment, thesurgical broach is advanced into the reamed cavity formed in the distalend of the femur during advancement of the distal end of the stem trialcomponent within the reamed intramedullary canal of the femur so as toform the surgically-prepared broached cavity in the distal end of thefemur.

In an embodiment, the stem trial component guides advancement of thesurgical broach during broaching of the distal end of the femur.

The canal reamer is removed from the intramedullary canal prior toadvancement of the distal end of the stem trial component within thereamed intramedullary canal.

The method also includes removing a previously-installed femoral implantfrom the femur of the patient prior to reaming the intramedullary canalof the femur with the canal reamer.

According to yet another aspect of the disclosure, a method ofsurgically preparing a knee of a patient includes reaming anintramedullary canal of a tibia of the patient with a tibial canalreamer, and thereafter broaching a proximal end of the tibia using asurgical broach secured to a stem trial component positioned in thereamed intramedullary canal of the tibia so as to form asurgically-prepared broached cavity in the proximal end of the tibia. Atibial cone augment is then installed in the broached cavity formed inthe proximal end of the tibia.

In an embodiment, the proximal end of the tibia is reamed using a conereamer secured to the stem trial component positioned in the reamedintramedullary canal of the tibia so as to form a surgically-preparedreamed cavity in the proximal end of the tibia prior to broaching theproximal end of the tibia. In such an embodiment, the surgical broach isadvanced into the reamed cavity formed in the proximal end of the tibia.

In an embodiment, the stem trial component guides advancement of thesurgical broach during broaching of the proximal end of the tibia.

The canal reamer is removed from the intramedullary canal prior toadvancement of the distal end of the stem trial component within thereamed intramedullary canal.

The method also includes removing a previously-installed tibial implantfrom the tibia of the patient prior to reaming the intramedullary canalof the tibia with the canal reamer.

According to a further aspect of the disclosure, a method of surgicallypreparing a knee of a patient includes reaming an intramedullary canalof a femur of the patient with a femoral canal reamer, and thereafterbroaching a distal end of the femur using a surgical broach secured to astem trial component positioned in the reamed intramedullary canal ofthe femur so as to form a surgically-prepared broached cavity in thedistal end of the femur. A femoral cone augment is then installed in thebroached cavity formed in the distal end of the femur.

In an embodiment, the distal end of the femur is reamed using a conereamer secured to the stem trial component positioned in the reamedintramedullary canal of the femur so as to form a surgically-preparedreamed cavity in the distal end of the femur prior to broaching thedistal end of the femur. In such an embodiment, the surgical broach isadvanced into the reamed cavity formed in the distal end of the femur.

In an embodiment, the stem trial component guides advancement of thesurgical broach during broaching of the distal end of the femur.

The canal reamer is removed from the intramedullary canal prior toadvancement of the distal end of the stem trial component within thereamed intramedullary canal.

The method also includes removing a previously-installed femoral implantfrom the femur of the patient prior to reaming the intramedullary canalof the femur with the canal reamer.

According to another aspect of the disclosure, an orthopaedic systemincludes a plurality of tibial cone augments configured to be implantedinto a surgically-prepared cavity in a proximal end of a tibia of apatient. Each of the plurality of tibial cone augments has (i) amedial/lateral augment taper angle that is the same as each of the otherof the plurality of tibial cone augments, and (ii) a medial/lateralaugment width that is different from each of the other of the pluralityof tibial cone augments. The orthopaedic system also includes aplurality of tibial surgical broaches having cutting teeth configured tocut and remove bone to form the surgically-prepared cavity in theproximal end of the tibia of the patient. Each of the plurality oftibial surgical broaches has (i) a medial/lateral broach taper anglethat is the same as each of the other of the plurality of tibialsurgical broaches, the medial/lateral broach taper angle being the sameas the medial/lateral augment taper angle, and (ii) a medial/lateralbroach width that is different from each of the other of the pluralityof tibial surgical broaches.

In an embodiment, each of the plurality of tibial cone augments has ananterior/posterior augment taper angle that is the same as each of theother of the plurality of tibial cone augments, and each of theplurality of tibial surgical broaches has an anterior/posterior broachtaper angle that is the same as each of the other of the plurality oftibial surgical broaches, with the anterior/posterior broach taper anglebeing the same as the anterior/posterior augment taper angle.

In an illustrative embodiment, each of the plurality of tibial coneaugments is embodied as a tri-lobe tibial cone augment. In anotherembodiment, each of the plurality of tibial cone augments is embodied asa bi-lobe tibial cone augment.

The orthopaedic system may also include a stem trial component having athreaded post extending from a proximal end thereof. In such anembodiment, each of the plurality of tibial surgical broaches has athreaded aperture formed in a distal end thereof that is sized tothreadingly receive the threaded post of the stem trial component.

According to a further aspect, an orthopaedic system includes aplurality of femoral cone augments configured to be implanted into asurgically-prepared cavity in a distal end of a femur of a patient. Eachof the plurality of femoral cone augments has (i) a medial/lateralaugment taper angle that is the same as each of the other of theplurality of femoral cone augments, and (ii) a medial/lateral augmentwidth that is different from each of the other of the plurality offemoral cone augments. The orthopaedic system also includes a pluralityof femoral surgical broaches having cutting teeth configured to cut andremove bone to form the surgically-prepared cavity in the distal end ofthe femur of the patient. Each of the plurality of femoral surgicalbroaches has (i) a medial/lateral broach taper angle that is the same aseach of the other of the plurality of femoral surgical broaches, themedial/lateral broach taper angle being the same as the medial/lateralaugment taper angle, and (ii) a medial/lateral broach width that isdifferent from each of the other of the plurality of femoral surgicalbroaches.

In an embodiment, each of the plurality of femoral cone augments has ananterior/posterior augment taper angle that is the same as each of theother of the plurality of femoral cone augments, and each of theplurality of femoral surgical broaches has an anterior/posterior broachtaper angle that is the same as each of the other of the plurality offemoral surgical broaches, with the anterior/posterior broach taperangle being the same as the anterior/posterior augment taper angle.

The orthopaedic system may also include a stem trial component having athreaded post extending from a proximal end thereof. In such anembodiment, each of the plurality of femoral surgical broaches has athreaded aperture formed in a distal end thereof that is sized tothreadingly receive the threaded post of the stem trial component.

According to yet another aspect of the disclosure, an orthopaedic systemincludes a plurality of knee cone augments configured to be implantedinto a surgically-prepared cavity in an end of a bone of a patient'sknee. Each of the plurality of knee cone augments has (i) amedial/lateral augment taper angle that is the same as each of the otherof the plurality of knee cone augments, and (ii) a medial/lateralaugment width that is different from each of the other of the pluralityof knee cone augments. The orthopaedic system also includes a pluralityof knee surgical broaches having cutting teeth configured to cut andremove bone to form the surgically-prepared cavity in the end of thebone of the patient's knee. Each of the plurality of knee surgicalbroaches has (i) a medial/lateral broach taper angle that is the same aseach of the other of the plurality of knee surgical broaches, themedial/lateral broach taper angle being the same as the medial/lateralaugment taper angle, and (ii) a medial/lateral broach width that isdifferent from each of the other of the plurality of knee surgicalbroaches.

In an embodiment, each of the plurality of knee cone augments has ananterior/posterior augment taper angle that is the same as each of theother of the plurality of knee cone augments, and each of the pluralityof knee surgical broaches has an anterior/posterior broach taper anglethat is the same as each of the other of the plurality of knee surgicalbroaches, with the anterior/posterior broach taper angle being the sameas the anterior/posterior augment taper angle.

In an illustrative embodiment, each of the plurality of knee coneaugments is embodied as a tri-lobe tibial cone augment. In anotherembodiment, each of the plurality of knee cone augments is embodied as abi-lobe tibial cone augment. In yet another illustrative embodiment,each of the plurality of knee cone augments is embodied as a femoralcone augment.

The orthopaedic system may also include a stem trial component having athreaded post extending from a proximal end thereof. In such anembodiment, each of the plurality of knee surgical broaches has athreaded aperture formed in a distal end thereof that is sized tothreadingly receive the threaded post of the stem trial component.

According to a further aspect of the disclosure, a method of surgicallypreparing an end of a bone of a patient's knee includes selecting a kneesurgical broach having cutting teeth configured to cut bone from aplurality of knee surgical broaches, wherein the selected knee surgicalbroach has a medial/lateral broach taper angle that is the same as eachof the other of the plurality of knee surgical broaches. The selectedbroach is then advanced into the end of the bone of the patient's kneeso as to form a surgically-prepared cavity therein. A knee cone augmentis then selected from a plurality of knee cone augments. The selectedknee cone augment has (i) a medial/lateral augment taper angle that isthe same as the medial/lateral broach taper angle, and (ii) amedial/lateral augment width that is smaller than a medial/lateralbroach width of the selected knee surgical broach. Thereafter, theselected knee cone augment is implanted into the surgically-preparedcavity formed in the end of the bone of the patient's knee.

In one embodiment, the selected knee cone augment is a tibial coneaugment that is implanted in a proximal end of a tibia of the patient'sknee. In another embodiment, the selected knee cone augment is atri-lobe tibial cone augment that is implanted in a proximal end of atibia of the patient's knee. In yet another embodiment, the selectedknee cone augment is a bi-lobe tibial cone augment that is implanted ina proximal end of a tibia of the patient's knee. In a furtherembodiment, the selected knee cone augment is a femoral cone augmentthat is implanted in a distal end of a femur of the patient's knee.

According to another aspect of the disclosure, an orthopaedic kneeimplant includes a modular tibial cone augment configured to beimplanted into a surgically-prepared cavity in a proximal end of a tibiaof a patient. The modular tibial cone augment includes a central lobecomponent having: (i) a round elongated body, (ii) a bore configured toreceive a stem of a revision tibial prosthesis extending through theelongated body, (iii) a medial connector formed in a medial side of theelongated body, and (iv) a lateral connector formed in a lateral side ofthe elongated body. The modular tibial cone augment also includes amedial lobe component having: (i) a body having a curved medial outersurface that tapers from a superior end to an inferior end thereof, (ii)a curved inner sidewall that corresponds in shape to the medial side ofthe elongated body of the central lobe component, and (iii) a medialconnector formed in the curved inner sidewall which mates with themedial connector of the central lobe component so as to selectively lockthe medial lobe component to the central lobe component. The modulartibial cone augment further includes a lateral lobe component having:(i) a body having a curved lateral outer surface that tapers from asuperior end to an inferior end thereof, (ii) a curved inner sidewallthat corresponds in shape to the lateral side of the elongated body ofthe central lobe component, and (iii) a lateral connector formed in thecurved inner sidewall which mates with the lateral connector of thecentral lobe component so as to selectively lock the lateral lobecomponent to the central lobe component.

In an embodiment, the medial connector of the central lobe component andthe medial connector of the medial lobe component define a dovetailjoint. In a similar embodiment, the lateral connector of the centrallobe component and the lateral connector of the lateral lobe componentalso define a dovetail joint.

In another embodiment, the medial connector of the central lobecomponent is embodied as a tapered slot formed in an outer surface ofthe elongated body, with the medial connector of the medial lobecomponent being embodied as a tapered tab extending outwardly from thecurved inner sidewall. The tapered tab of the medial lobe component isconfigured to be received into the tapered slot of the central lobecomponent so as to selectively lock the medial lobe component to thecentral lobe component.

In another embodiment, the lateral connector of the central lobecomponent is embodied as a tapered slot formed in an outer surface ofthe elongated body, with the lateral connector of the lateral lobecomponent being embodied as a tapered tab extending outwardly from thecurved inner sidewall. The tapered tab of the lateral lobe component isconfigured to be received into the tapered slot of the central lobecomponent so as to selectively lock the lateral lobe component to thecentral lobe component.

In an embodiment, a porous-metal coating is disposed on the outersurfaces of central lobe component, the medial lobe component, and thelateral lobe component.

The bore of the central lobe component is defined by a conically-shapedsidewall extending through the elongated body of the central lobecomponent, and the conically-shaped sidewall may have a number cementpockets formed therein.

According to another aspect of the disclosure, an orthopaedic kneeimplant includes a modular tibial cone augment configured to beimplanted into a surgically-prepared cavity in a proximal end of a tibiaof a patient. The modular tibial cone augment includes a central lobecomponent having: (i) a round elongated body, (ii) a bore configured toreceive a stem of a revision tibial prosthesis extending through theelongated body, and (iii) a connector formed in a side of the elongatedbody. The modular tibial cone augment also includes a side lobecomponent having: (i) a body having a curved outer surface that tapersfrom a superior end to an inferior end thereof, (ii) a curved innersidewall that corresponds in shape to the side of the elongated body ofthe central lobe component, and (iii) a connector formed in the curvedinner sidewall which mates with the connector of the central lobecomponent so as to selectively lock the side lobe component to thecentral lobe component.

In an embodiment, the connector of the central lobe component and theconnector of the side lobe component define a dovetail joint.

In another embodiment, the connector of the central lobe component isembodied as a tapered slot formed in an outer surface of the elongatedbody, with the connector of the side lobe component being embodied as atapered tab extending outwardly from the curved inner sidewall. Thetapered tab of the side lobe component is configured to be received intothe tapered slot of the central lobe component so as to selectively lockthe side lobe component to the central lobe component.

The side lobe component may be embodied as a medial lobe component or alateral lobe component.

In an embodiment, a porous-metal coating is disposed on the outersurfaces of central lobe component and the side lobe component.

The bore of the central lobe component is defined by a conically-shapedsidewall extending through the elongated body of the central lobecomponent, and the conically-shaped sidewall may have a number cementpockets formed therein.

According to a further aspect of the disclosure, a method of surgicallypreparing a proximal end of a tibia of a patient includes determining acondition of bone tissue of the proximal end of the tibia of thepatient, and thereafter forming a surgically-prepared cavity in theproximal end of the tibia of the tibia of a patient. A modular tibialcone augment is then assembled which corresponds to the shape of thesurgically-prepared cavity by locking a side lobe component to a centrallobe component, with the central lobe component having bore extendingtherethrough that is configured to receive a stem of a revision tibialprosthesis. The assembled modular tibial cone augment is then installedin the surgically-prepared cavity formed in the proximal end of thetibia.

In an embodiment, the side lobe component is embodied as a medial lobecomponent assembled to a medial side of the central lobe component.

In another embodiment, the side lobe component is embodied as a laterallobe component assembled to a lateral side of the central lobecomponent.

In a further embodiment, the lobe component is embodied as a medial lobecomponent and a lateral lobe component. In such a case, the medial lobecomponent is assembled to a medial side of the central lobe component,and the lateral lobe component is assembled to a lateral side of thecentral lobe component.

According to yet another aspect of the disclosure, an orthopaedic kneeimplant includes a knee cone augment configured to be implanted into asurgically-prepared cavity in an end of a bone of a patient's knee. Theknee cone augment includes a round elongated body having a superior endand an inferior end and a bore configured to receive a stem of arevision knee prosthesis extending through the elongated body. The boreis defined by a conically-shaped inner sidewall extending through theelongated body between its superior end and its inferior end. A numberof impact lugs are secured to the inner sidewall at a location betweenthe superior end and the inferior end of the elongated body. Each of thenumber of impact lugs extends inwardly from the inner sidewall toward acentral axis of the bore, and has a flat, inferior-most impact surface.

In one example, the knee cone augment is embodied as a femoral coneaugment configured to be implanted into a surgically-prepared cavity ina distal end of a femur of the patient's knee.

In an embodiment, each of the number of impact lugs includes a curvedouter body extending superiorly from the impact surface. In such anexample, the curved outer body of each of the number of impact lugs maybe tapered in the superior/inferior direction such that a superior endthereof blends into the inner sidewall.

In an embodiment, the number of impact lugs includes a medial impact lugsecured to a medial side of the inner sidewall and a lateral impact lugsecured to a lateral side of the inner sidewall.

In an illustrative embodiment, the knee cone augment is embodied as afemoral cone augment configured to be implanted into asurgically-prepared cavity in a distal end of a femur of the patient'sknee. The femoral cone augment has box cutout formed in a posterior sidethereof, with the box cutout being configured to receive a box of arevision femoral prosthesis. The box cutout is defined in part by aflat, inferior-facing surface. The impact surface of each of the numberof impact lugs is coplanar with the flat, inferior-facing surface of thebox cutout.

In an embodiment, the impact surfaces of each of the number of impactlugs are coplanar with one another.

The inner sidewall may have a number cement pockets formed therein.

According to another aspect of the disclosure, an orthopaedic kneeimplant includes a femoral cone augment configured to be implanted intoa surgically-prepared cavity in a distal end of a femur of a patient'sknee. The femoral cone augment includes a round elongated body having asuperior end and an inferior end and a bore configured to receive a stemof a revision femoral prosthesis extending through the elongated body.The bore is defined by a conically-shaped inner sidewall extendingthrough the elongated body between its superior end and its inferiorend. The femoral cone augment also includes a pair of impact lugssecured to the inner sidewall at a location between the superior end andthe inferior end of the elongated body. Both of the pair of impact lugsextend inwardly from the inner sidewall toward a central axis of thebore, and have a flat, inferior-most impact surface.

In an embodiment, both of the pair of impact lugs include a curved outerbody extending superiorly from the impact surface. In such anembodiment, the curved outer body of both of the pair of impact lugs maybe tapered in the superior/inferior direction such that a superior endthereof blends into the inner sidewall.

The pair of impact lugs may include a medial impact lug secured to amedial side of the inner sidewall and a lateral impact lug secured to alateral side of the inner sidewall.

The femoral cone augment may have a box cutout formed in a posteriorside thereof. The box cutout is configured to receive a box of therevision femoral prosthesis and is defined in part by a flat,inferior-facing surface. The impact surface of both of the pair ofimpact lugs is coplanar with the flat, inferior-facing surface of thebox cutout.

The impact surface of each of the number of impact lugs may be coplanarwith one another.

The inner sidewall may have a number cement pockets formed therein.

According to a further aspect, an orthopaedic knee system includes aknee cone augment configured to be implanted into a surgically-preparedcavity in an end of a bone of a patient's knee. The knee cone augmentincludes a round elongated body having a superior end and an inferiorend and a bore configured to receive a stem of a revision kneeprosthesis extending through the elongated body. The bore is defined bya conically-shaped inner sidewall extending through the elongated bodybetween its superior end and its inferior end. The knee cone augmentalso includes a number of impact lugs secured to the inner sidewall at alocation between the superior end and the inferior end of the elongatedbody. Each of the number of impact lugs has a flat impact surface. Theorthopaedic knee system also includes an impactor head configured toimpact the knee cone augment during a surgical procedure to implant theknee cone augment. The impactor head has a proximal surface configuredto be secured to an impaction handle and an impact surface opposite theproximal surface. The impact surface has a number of impact shouldersformed therein. Each of the number of impact shoulders has a flat impactsurface that is sized and shaped to be positioned on the flat impactsurface of one of the number of impact lugs of the knee cone augmentwhen the impactor head is used to impact the knee cone augment.

In an example, the knee cone augment is embodied as a femoral coneaugment configured to be implanted into a surgically-prepared cavity ina distal end of a femur of the patient's knee.

Each of the number of impact lugs may include a curved outer bodyextending away from the impact surface of the impact lug. The impactorhead may have a number of guide slots formed therein, with each of theimpact shoulders defining a proximal end of one of the number of guideslots. Each of the number of impact lugs of the knee cone implant isreceived into one of the number of guide slots of the impactor head whenthe impactor head is used to impact the knee cone augment.

The number of impact lugs may include a medial impact lug secured to amedial side of the inner sidewall and a lateral impact lug secured to alateral side of the inner sidewall. In such an embodiment, the number ofimpact shoulders includes a medial impact shoulder formed in a medialside of the impactor head and a lateral impact shoulder formed in alateral side of the impactor head.

In an example, the knee cone augment is embodied as a femoral coneaugment configured to be implanted into a surgically-prepared cavity ina distal end of a femur of the patient's knee. The femoral cone augmenthas box cutout formed in a posterior side thereof, with the box cutoutbeing configured to receive a box of a revision femoral prosthesis. Thebox cutout is defined in part by a flat, inferior-facing surface. Theimpact surface of the impactor head has an impact lip formed therein,with the impact lip having a flat impact surface that is sized andshaped to be positioned on the flat, inferior-facing surface of the boxcutout when the impactor head is used to impact the knee cone augment.

The impact surface of each of the number of impact lugs of the femoralcone augment may be coplanar with the flat, inferior-facing surface ofthe box cutout of the femoral cone augment. In such an embodiment, theflat impact surface of each of the number of impact shoulders of theimpactor head is coplanar with the flat impact surface of the impact lipof the impactor head.

According to another aspect, a method of surgically preparing a knee ofa patient includes forming a surgically-prepared cavity in an end of abone of the knee of the patient and thereafter positioning a knee coneaugment in the cavity formed in the end of the bone. The knee coneaugment has a bore formed therein and a number of impact lugs positionedin the bore. A distal end of an impactor head is advanced into the boreof knee cone augment such that a number of impact shoulders of theimpactor head are positioned in contact with the number of impact lugsof the knee cone augment. Thereafter, the impactor head is impacted suchthat impaction forces are transferred from the number of impactshoulders of the impactor head to the number of impact lugs of the kneecone augment.

In an example, the knee cone augment is embodied as a femoral coneaugment configured to be implanted into a surgically-prepared cavity ina distal end of a femur of the patient's knee. The femoral cone augmenthas box cutout formed in a posterior side thereof. The box cutout isconfigured to receive a box of a revision femoral prosthesis, anddefined in part by a flat, inferior-facing surface. In such anembodiment, the distal end of an impactor head is advanced into the boreof the femoral cone augment such that an impact lip of the impactor headis positioned in contact with the flat, inferior-facing surface of thebox cutout of the femoral cone augment. Impaction of the impactor headcauses impaction forces to be transferred from the impact lip of theimpactor head to the flat, inferior-facing surface of the box cutout ofthe femoral cone augment.

The method further includes removing a previously-installed knee implantfrom the end of a bone of the knee of the patient prior to forming thecavity in the end of the bone of the knee of the patient.

According to another aspect of the disclosure, an orthopaedic kneesystem includes a pair of knee cone components configured to beinstalled into a surgically-prepared cavity in an end of a bone of apatient's knee. Each of the pair of knee cone components has aconically-shaped hollow body configured to receive a stem of a revisionknee prosthesis therethrough. The hollow body of both of the pair ofknee cone components has a first end that tapers downwardly to a secondend, with the first end of the hollow body defining an annular rimextending radially between an inner sidewall and an outer sidewall ofthe hollow body. The annular rim of a first knee cone component of thepair of knee cone components has an inner diameter that is smaller thanan inner diameter of the annular rim of a second knee component of thepair of knee cone components. The orthopaedic knee system also includesan impactor head configured to impact the pair of knee cone componentsduring a surgical procedure. The impactor head includes a proximalsurface configured to be secured to an impaction handle and an impactsurface opposite the proximal surface. The impact surface has a pair ofannular-shaped concentric impact flanges formed therein. A first impactflange of the pair of impact flanges has a diameter that is larger thanthe inner diameter of the annular rim of the first knee cone componentof the pair of knee cone components, but smaller than the inner diameterof the annular rim of the second knee cone component of the pair of kneecone components. A second impact flange of the pair of impact flangeshas a diameter that is larger than the inner diameters of the annularrims of both the first knee cone component and the second knee conecomponent of the pair of knee cone components.

In an embodiment, the impact surface of the impactor head further has anannular-shaped lead-in flange that is concentric with the pair of impactflanges. The lead-in flange has a diameter that is smaller than theinner diameters of the annular rims of both the first knee conecomponent and the second knee cone component of the pair of knee conecomponents.

In an example, the pair of knee cone components is embodied as a pair ofknee cone trial components.

In another example, the pair of knee cone components is embodied as apair of femoral cone augments configured to be implanted into asurgically-prepared cavity in a distal end of a femur of the patient'sknee.

The pair of knee cone components may also be embodied as a pair oftibial cone augments configured to be implanted into asurgically-prepared cavity in a proximal end of a tibia of the patient'sknee.

Yet further, the pair of knee cone components may be embodied as a pairof concentric knee cone augments configured to be implanted into one orboth of a surgically-prepared cavity in a distal end of a femur of thepatient's knee and a surgically-prepared cavity in a proximal end of atibia of the patient's knee.

According to another aspect, an orthopaedic knee system includes a firstconically-shaped concentric knee cone component configured to beinstalled into a surgically-prepared cavity in an end of a bone of apatient's knee. The first concentric knee component has an annular rimwith an inner diameter. The orthopaedic knee system also includes asecond conically-shaped concentric knee cone component configured to beinstalled into the surgically-prepared cavity in the end of the bone ofthe patient's knee. The second concentric knee component has an annularrim with an inner diameter. The inner diameter of the annular rim of thesecond concentric knee cone component is larger than the inner diameterof the annular rim of the first concentric knee cone component. Theorthopaedic knee system also includes an impactor head configured toimpact the first knee cone component and the second knee cone componentduring a surgical procedure. The impactor head includes a proximalsurface configured to be secured to an impaction handle and an impactsurface opposite the proximal surface. The impact surface has a pair ofannular-shaped concentric impact flanges formed therein. A first impactflange of the pair of impact flanges has a diameter that is larger thanthe inner diameter of the annular rim of the first knee cone component,but smaller than the inner diameter of the annular rim of the secondknee cone component. A second impact flange of the pair of impactflanges has a diameter that is larger than the inner diameters of theannular rims of both the first knee cone component and the second kneecone component.

The impact surface of the impactor head further has an annular-shapedlead-in flange that is concentric with the pair of impact flanges. Thelead-in flange has a diameter that is smaller than the inner diametersof the annular rims of both the first knee cone component and the secondknee cone component.

The first knee cone component and the second knee cone component may beembodied as a pair of knee cone trial components.

The first knee cone component and the second knee cone component may beembodied a pair of femoral cone augments configured to be implanted intoa surgically-prepared cavity in a distal end of a femur of the patient'sknee.

The first knee cone component and the second knee cone component may beembodied a pair of tibial cone augments configured to be implanted intoa surgically-prepared cavity in a proximal end of a tibia of thepatient's knee.

The first knee cone component and the second knee cone component areconfigured to be implanted into one or both of a surgically-preparedcavity in a distal end of a femur of the patient's knee and asurgically-prepared cavity in a proximal end of a tibia of the patient'sknee.

According to yet another aspect of the disclosure, a method ofsurgically preparing a knee of a patient includes forming asurgically-prepared cavity in an end of a bone of the knee of thepatient. A knee cone augment is selected from a pair of knee coneaugments that includes a first knee cone augment and a second knee coneaugment, the first knee cone augment having an annular rim that issmaller than an annular rim of the second knee cone augment. Theselected knee cone augment is positioned in the cavity formed in the endof the bone. Thereafter, a distal end of an impactor head is advancedinto a bore of the selected knee cone augment such that a smaller impactflange of a pair of annular-shaped concentric impact flanges formed inthe impactor head is positioned in contact with the annular rim of theselected knee cone augment if the selected knee cone augment is thefirst knee cone component. Or, the smaller impact flange of the pair ofannular-shaped concentric impact flanges of the impactor head ispositioned in the bore of the selected knee cone component and a largerimpact flange of the pair of annular-shaped concentric impact flanges ofthe impactor head is positioned in contact with the annular rim of theselected knee cone augment if the selected knee cone augment is thesecond knee cone component. The impactor head is then impacted such thatimpaction forces are transferred from one of the pair of annular-shapedconcentric impact flanges of the impactor head to the selected knee coneaugment.

In an embodiment, the impactor head has an annular-shaped lead-in flangethat is concentric with the pair of annular-shaped concentric impactflanges. The lead-in flange is advanced into the bore of the selectedknee cone augment during advancement of the distal end of the impactorhead.

In an embodiment, the surgically-prepared cavity is formed in a distalend of a femur of the knee of the patient and the selected knee coneaugment is positioned in the cavity formed in the distal end of thefemur of the knee of the patient.

In an embodiment, the surgically-prepared cavity is formed in a proximalend of a tibia of the knee of the patient and the selected knee coneaugment is positioned in the cavity formed in the proximal end of thetibia of the knee of the patient.

The method may also include removing a previously-installed knee implantfrom the end of a bone of the knee of the patient prior to forming thecavity in the end of the bone of the knee of the patient.

According to a further aspect of the present disclosure, an orthopaedicknee system includes a plurality of knee cone trial componentsconfigured to be installed into a surgically-prepared cavity in an endof a bone of a patient's knee. Each of the plurality of knee conecomponents has a conically-shaped hollow body configured to receive astem trial component therethrough. The hollow body of each of theplurality of knee cone trial components has a pair of extractionopenings formed therein, with each of the pair of extraction openingsbeing positioned on opposite sides of the hollow body from the other.Each of the pair of extraction openings extends between an innersidewall and an outer sidewall of the hollow body. The orthopaedic kneesystem also includes a trial extractor operable to extract each of theplurality of knee cone trial components from the surgically-preparedcavity in the end of the bone of the patient's knee. The trial extractorincludes a connector body configured to be secured to an impactionhandle and a pair of extractor arms pivotally coupled to the connectorbody. Each of the pair of extractor arms has a prong formed in a distalend thereof. The prong of each of the pair of extractor arms is sizedand shaped to be received into one of the extraction openings formed ineach of the plurality of knee cone trial components. The trial extractoralso includes a spring asserting a spring bias on the pair of extractorarms so as to urge the prongs away from one another.

The connector body of the trial extractor may also include a pair ofmounting flanges spaced apart from one another, with each of the pair ofmounting flanges having an aperture defined therein. A proximal end ofeach of the pair of extractor arms has an aperture defined therein. Thetrial extractor further comprises a pivot pin. The pivot pin ispositioned in the aperture of each of the pair of mounting flanges andthe aperture of each of the pair of extractor arms so as to pivotallycouple the pair of extractor arms to the connector body.

In an embodiment, the proximal end of each of the pair of extractor armsis positioned between the pair of mounting flanges.

In an example, the spring is embodied a torsion spring having a loop anda pair of spring arms. Each of the pair of spring arms is biased againstone of the pair of extractor arms, and the pivot pin extends through theloop.

In an embodiment, each of the pair of extraction openings is diamondshaped and each of the prongs formed in the pair of extractor armscomprises a pointed tip that is sized and shaped to be received into oneof the diamond shaped extraction openings.

A first extraction opening of the pair of extraction openings may bepositioned on a medial side of the hollow body, and a second extractionopening of the pair of extraction openings may be positioned on alateral side of the hollow body.

The plurality of knee cone trial components may be embodied as aplurality of femoral cone trial components configured to be installedinto a surgically-prepared cavity in a distal end of a femur of thepatient's knee.

The plurality of knee cone trial components may be embodied as aplurality of tibial cone trial components configured to be installedinto a surgically-prepared cavity in a proximal end of a tibia of thepatient's knee.

The plurality of knee cone trial components may be embodied as aplurality of concentric knee cone trial components configured to beinstalled into one or both of a surgically-prepared cavity in a distalend of a femur of the patient's knee and a surgically-prepared cavity ina proximal end of a tibia of the patient's knee.

According to another aspect of the disclosure, an orthopaedic kneeinstrument assembly includes an impaction handle having an elongatedbody, an impact plate secured to a proximal end of the elongated body,and a connector positioned on a distal end of the elongated bodyopposite the impact plate. The orthopaedic knee instrument assembly alsoincludes a trial extractor removabley secured to the impaction handle.The trial extractor includes a connector body having a connectorconfigured to be secured to the connector of the impaction handle and apair of extractor arms pivotally coupled to the connector body. Each ofthe pair of extractor arms has a prong formed in a distal end thereof.The prong of each of the pair of extractor arms being sized and shapedto be received into an extraction opening formed in a knee cone trialcomponent. The trial extractor also includes a spring asserting a springbias on the pair of extractor arms so as to urge the prongs away fromone another.

The connector body of the trial extractor may also include a pair ofmounting flanges spaced apart from one another, with each of the pair ofmounting flanges having an aperture defined therein. A proximal end ofeach of the pair of extractor arms has an aperture defined therein. Thetrial extractor further comprises a pivot pin. The pivot pin ispositioned in the aperture of each of the pair of mounting flanges andthe aperture of each of the pair of extractor arms so as to pivotallycouple the pair of extractor arms to the connector body.

In an embodiment, the proximal end of each of the pair of extractor armsis positioned between the pair of mounting flanges.

In an example, the spring is embodied a torsion spring having a loop anda pair of spring arms. Each of the pair of spring arms is biased againstone of the pair of extractor arms, and the pivot pin extends through theloop.

In an embodiment, each of the prongs formed in the pair of extractorarms includes a pointed tip that is sized and shaped to be received intoa diamond shaped extraction opening.

According to another aspect of the disclosure, a method of surgicallypreparing a knee of a patient includes forming a surgically-preparedcavity in an end of a bone of the knee of the patient and positioning aknee cone trial component in the cavity formed in the end of the bone.Thereafter, the knee of the patient is moved through a trial range ofmotion. A trial extractor is then advanced such that a distal end ofeach of a pair of extractor arms of the trial extractor is positioned ina bore of the knee cone trial component. The distal end of each of thepair of extractor arms has a prong formed therein, with such a prong ofeach of the pair of extractor arms being positioned into one of a pairof extraction openings formed in the knee cone trial component. Anextraction force is asserted on the trial extractor so as to extract theknee cone trial component from the cavity formed in the end of the bone.

The pair of extractor arms may be squeezed toward one another duringadvancement into the bore of the knee cone trial component. The pair ofextractor arms are then released so as to allow a spring bias to urgethe prongs formed in the distal end of each of the pair of extractorarms away from one another and into the pair of extraction openingsformed in the knee cone trial component.

In an embodiment, the surgically-prepared cavity is formed in a distalend of a femur of the knee of the patient and the knee cone trialcomponent is positioned in the cavity formed in the distal end of thefemur of the knee of the patient.

In an embodiment, the surgically-prepared cavity is formed in a proximalend of a tibia of the knee of the patient and the knee cone trialcomponent is positioned in the cavity formed in the proximal end of thetibia of the knee of the patient.

The method may also include removing a previously-installed knee implantfrom the end of a bone of the knee of the patient prior to forming thecavity in the end of the bone of the knee of the patient.

BRIEF DESCRIPTION OF THE DRAWINGS

The detailed description particularly refers to the following figures,in which:

FIG. 1 is perspective view of tibial cone augment for use with arevision knee prosthesis;

FIG. 2 is an anterior view of the tibial cone augment of FIG. 1 ;

FIG. 3 is a superior view of the tibial cone augment of FIG. 1 ;

FIG. 4 is an inferior view of the tibial cone augment of FIG. 1 ;

FIG. 5 is a perspective view of a tibial surgical broach for use in anorthopaedic surgical procedure to implant the tibial cone augment ofFIGS. 1-4 ;

FIG. 6 is an inferior view of the tibial surgical broach of FIG. 5 ;

FIG. 7 is an anterior view of the tibial surgical broach of FIG. 5 ;

FIG. 8 is a diagrammatic view showing multiple sizes of the tibial coneaugment of FIGS. 1-4 superimposed on one another, as viewed in themedial/lateral direction;

FIG. 9 is a diagrammatic view showing multiple sizes of the tibial coneaugment of FIGS. 1-4 superimposed on one another, as viewed in theanterior/posterior direction;

FIG. 10 is a diagrammatic view showing multiple sizes of the tibialsurgical broach of FIGS. 5-7 superimposed on one another, as viewed inthe medial/lateral direction;

FIG. 11 is a diagrammatic view showing multiple sizes of the tibialsurgical broach of FIGS. 5-7 superimposed on one another, as viewed inthe anterior/posterior direction;

FIG. 12 is perspective view of femoral cone augment for use with arevision knee prosthesis;

FIG. 13 is an anterior view of the femoral cone augment of FIG. 12 ;

FIG. 14 is a posterior view of the tibial cone augment of FIG. 12 ;

FIG. 15 is a perspective view of a femoral surgical broach for use in anorthopaedic surgical procedure to implant the femoral cone augment ofFIGS. 12-14 ;

FIG. 16 is an inferior view of the femoral surgical broach of FIG. 15 ;

FIG. 17 is an anterior view of the femoral surgical broach of FIG. 15 ;

FIG. 18 is a diagrammatic view showing multiple sizes of the femoralcone augment of FIGS. 12-14 superimposed on one another, as viewed inthe medial/lateral direction;

FIG. 19 is a diagrammatic view showing multiple sizes of the femoralcone augment of FIGS. 12-14 superimposed on one another, as viewed inthe anterior/posterior direction;

FIG. 20 is a diagrammatic view showing multiple sizes of the femoralsurgical broach of FIGS. 15-17 superimposed on one another, as viewed inthe medial/lateral direction;

FIG. 21 is a diagrammatic view showing multiple sizes of the femoralsurgical broach of FIGS. 15-17 superimposed on one another, as viewed inthe anterior/posterior direction;

FIG. 22 is a perspective view of a cone reamer;

FIG. 23 is a side view of the cone reamer of FIG. 22 ;

FIG. 24 is an end view of the cone reamer of FIG. 22 ;

FIGS. 25-31 illustrate a number of steps of a surgical procedure toimplant the tibial cone augment of FIGS. 1-4 ;

FIGS. 32-36 illustrate a number of steps of a surgical procedure toimplant the femoral cone augment of FIGS. 12-14 ;

FIG. 37 is a perspective view of a central lobe component of a modulartibial cone augment;

FIG. 38 is a perspective view of a lateral lobe component of a modulartibial cone augment;

FIG. 39 is a perspective view of a medial lobe component of a modulartibial cone augment;

FIG. 40 is a perspective view showing the lobe components of FIGS. 37-39assembled as a modular tri-lobe tibial cone augment;

FIG. 41 is a perspective view showing the lobe components of FIGS. 37and 38 assembled as a modular bi-lobe tibial cone augment;

FIG. 42 is another perspective view of the femoral cone augment of FIG.12 ;

FIG. 43 is an inferior view of the femoral cone augment of FIG. 12 ;

FIG. 44 is a cross sectional view of the femoral cone augment takenalong the line 44-44 of FIG. 43 , as viewed in the direction of thearrows;

FIG. 45 is a cross sectional view of the femoral cone augment takenalong the line 45-45 of FIG. 43 , as viewed in the direction of thearrows;

FIG. 46 is a perspective view of a femoral cone trial component;

FIG. 47 is an inferior view of the femoral cone trial component of FIG.46 ;

FIG. 48 is a cross sectional view of the femoral cone trial componenttaken along the line 48-48 of FIG. 47 , as viewed in the direction ofthe arrows;

FIG. 49 is a side elevation view of the femoral cone trial component ofFIG. 46 ;

FIG. 50 is a perspective view of an impactor head for use in installingthe femoral cone augment of FIGS. 12-14 and 42-49 , along with thefemoral cone trial component of FIGS. 46-49 ;

FIG. 51 is a side elevation view of the impactor head of FIG. 50 ;

FIG. 52 is a perspective view showing the distal end of the impactorhead of FIG. 50 ;

FIG. 53 illustrates the impactor head of FIG. 50 being used in asurgical procedure to implant the femoral cone augment of FIGS. 12-14and

FIG. 54 illustrates the impactor head of FIG. 50 positioned in contactwith the femoral cone augment of FIGS. 12-14 and 42-45 ;

FIG. 55 is a cross sectional view taken along the line 55-55 of FIG. 54, as viewed in the direction of the arrows;

FIG. 56 is a cross sectional view taken along the line 56-56 of FIG. 54, as viewed in the direction of the arrows;

FIG. 57 illustrates the impactor head of FIG. 50 positioned in contactwith the femoral cone trial component of FIGS. 46-49 ;

FIG. 58 is a cross sectional view taken along the line 58-58 of FIG. 57, as viewed in the direction of the arrows;

FIG. 59 is a cross sectional view taken along the line 59-59 of FIG. 57, as viewed in the direction of the arrows;

FIG. 60 is a perspective view of a concentric cone augment;

FIG. 61 is an elevation view of the proximal end of the concentric coneaugment of FIG. 60 ;

FIG. 62 is a cross sectional view of the concentric cone augment takenalong the line 62-62 of FIG. 61 , as viewed in the direction of thearrows;

FIG. 63 is a perspective view of a concentric cone trial component;

FIG. 64 is an elevation view of the proximal end of the concentric conetrial component of FIG. 63 ;

FIG. 65 is a cross sectional view of the concentric cone trial componenttaken along the line 65-65 of FIG. 64 , as viewed in the direction ofthe arrows;

FIG. 66 is a perspective view of an impactor head for installing theconcentric cone augment of FIGS. 60-62 and the concentric cone trialcomponent of FIGS. 63-65 ;

FIG. 67 is an elevation view of the impactor head of FIG. 66 ;

FIG. 68 is a cross sectional view of the impactor head taken along theline 68-68 of FIG. 67 , as viewed in the direction of the arrows;

FIG. 69 is an elevation view of the distal end of the impactor head ofFIG. 66 ;

FIG. 70 illustrates the impactor head of FIG. 66 being used in asurgical procedure to implant the concentric cone augment of FIGS. 60-62into the proximal end of the tibia of a patient;

FIG. 71 illustrates the impactor head of FIG. 66 being used in asurgical procedure to implant the concentric cone augment of FIGS. 60-62into the distal end of the femur of a patient;

FIGS. 72 and 73 illustrate the impactor head of FIG. 60 positioned incontact with two different sizes of the concentric cone augments ofFIGS. 60-62 , note the concentric cone augment of FIG. 73 is larger thanthe concentric cone augment of FIG. 72 ;

FIGS. 74 and 75 illustrate the impactor head of FIG. 60 positioned incontact with two different sizes of the concentric cone trial componentsof FIGS. 63-65 , note the concentric cone trial component of FIG. 75 islarger than the concentric cone trial component of FIG. 74 ;

FIG. 76 is an exploded perspective view of a trial extractor;

FIG. 77 is an assembled perspective view of the trial extractor of FIG.76 ;

FIG. 78 is a side elevation view of the trial extractor of FIG. 76 ;

FIG. 79 illustrates the trial extractor of FIG. 76 being used in asurgical procedure to extract the concentric cone trial component ofFIGS. 63-65 from the distal end of the femur of a patient;

FIG. 80 is a perspective view of a tibial cone trial component;

FIG. 81 is a superior view of the tibial cone trial component of FIG.

80;

FIG. 82 is an anterior view of the tibial cone trial component of FIG.80 ; and

FIG. 83 is a perspective view of an impaction handle.

DETAILED DESCRIPTION OF THE DRAWINGS

While the concepts of the present disclosure are susceptible to variousmodifications and alternative forms, specific exemplary embodimentsthereof have been shown by way of example in the drawings and willherein be described in detail. It should be understood, however, thatthere is no intent to limit the concepts of the present disclosure tothe particular forms disclosed, but on the contrary, the intention is tocover all modifications, equivalents, and alternatives falling withinthe spirit and scope of the invention as defined by the appended claims.

Terms representing anatomical references, such as anterior, posterior,medial, lateral, superior, inferior, etcetera, may be used throughoutthe specification in reference to the orthopaedic implants andorthopaedic surgical instruments described herein as well as inreference to the patient's natural anatomy. Such terms havewell-understood meanings in both the study of anatomy and the field oforthopaedics. Use of such anatomical reference terms in the writtendescription and claims is intended to be consistent with theirwell-understood meanings unless noted otherwise.

The exemplary embodiments of the present disclosure are described andillustrated below to encompass prosthetic knee joints and knee jointcomponents, as well as methods of implanting and reconstructing kneejoints. It will also be apparent to those of ordinary skill in the artthat the preferred embodiments discussed below are exemplary in natureand may be reconfigured without departing from the scope and spirit ofthe present invention. However, for clarity and precision, the exemplaryembodiments as discussed below may include optional steps, methods, andfeatures that one of ordinary skill should recognize as not being arequisite to fall within the scope of the present invention.

Various illustrative embodiments of knee cone augments are disclosedherein. Consistent with its usage in the art, what is meant herein bythe term “cone augment” is an augment component that is not mechanicallylocked or otherwise secured to a revision knee prosthesis prior toimplantation of the prosthesis, but rather is first separately implantedinto the bone of the patient and thereafter secured to the subsequentlyimplanted revision knee prosthesis, if secured to it at all, by use ofan adhesive, such as bone cement. As a result, when installed inconjunction with the revision knee prosthesis, the cone augment does notphysically contact the revision knee prosthesis, but rather ismechanically secured to it by the adhesive (e.g., bone cement), ifsecured to the revision knee prosthesis at all (e.g., the cone augmentis not secured at all to a press-fit (i.e., cementless) stem component).As such, as used herein, a cone augment is distinct from a sleeveaugment given sleeve augments are mechanically locked to a revision kneeprosthesis prior to implantation of the prosthesis.

Referring now to FIGS. 1-11 , an orthopaedic joint replacement system 10includes a number of orthopaedic prosthetic components such as a tibialcone augment 12 and a number of orthopaedic surgical instruments such asa tibial surgical broach 14 (see, for example, FIGS. 5-7 ) for use inpreparing the bone to receive one or more of the tibial cone augments12. What is meant herein by the term “orthopaedic surgical instrument”or “orthopaedic surgical instrument system” is a surgical tool for useby a surgeon in performing an orthopaedic surgical procedure. As such,it should be appreciated that, as used herein, the terms “orthopaedicsurgical instrument” and “orthopaedic surgical instruments” are distinctfrom orthopaedic prosthetic components or implants, such as those shownin FIGS. 1-4 .

The tibial cone augment 12 includes an elongated hollow body 16 having acentral lobe section 20, a medial lobe section 22, and a lateral lobesection 24. It should be appreciated that although the tibial coneaugment 12 is herein shown as a tri-lobe tibial augment (i.e., it hasthree lobe sections 20, 22, 24), the tibial cone augment 12 may beembodied as a bi-lobe tibial augment (i.e., having a central lobesection 20 and only one of the medial lobe section 22 or the laterallobe section 24, but not both) or a concentric tibial augment (i.e.,having a central lobe section 20, but neither the medial lobe section 22nor the lateral lobe section 24). A bore 18 defined by the hollow body16 in the central lobe section 20 is sized and shaped to receive atibial stem component of a tibial revision prosthesis (not shown).Moreover, the size and shape of the bores 26, 28 defined by the hollowbody 16 in the medial lobe section 22 and lateral lobe section 24,respectively, allow the position of the tibial stem component of thetibial revision prosthesis to be offset in the medial/lateral directionfrom the central lobe section as needed to fit the needs of a givensurgical installation. Moreover, the bores 18, 26, 28 defined by thehollow body 16 allow for receipt of structures on the inferior side of arevision tibial tray such as one or more keels.

The body 16 of the tibial cone augment 12 is illustratively embodied asa solid-metal base 32 having a porous-metal coating 30 disposed thereon.It should be appreciated that the porous-metal coating 30 could be aseparately-applied coating such as Porocoat® Porous Coating which iscommercially available from DePuy Synthes of Warsaw, Indiana. However,in the illustrative embodiment described herein, the porous-metalcoating 30 is disposed on the solid-metal base 32 by virtue of beingadditively manufactured contemporaneously with the solid-metal base 32so as to create a common, monolithic component of the two metalstructures.

In one example, the porous-metal coating 30 may be made of a porousmaterial as described in U.S. patent application Ser. No. 16/365,557,which was filed Mar. 26, 2019 and is assigned to the same assignee asthe present disclosure, the disclosure of which is hereby incorporatedby reference as if set forth in its entirety herein. Additivemanufacturing processes can include, by way of example, powder bedfusion printing, such as melting and sintering, cold spray 3D printing,wire feed 3D printing, fused deposition 3D printing, extrusion 3Dprinting, liquid metal 3D printing, stereolithography 3D printing,binder jetting 3D printing, material jetting 3D printing, and the like.

In one example, the porous material of the porous-metal coating 30 maybe defined by a porous three-dimensional structure that includes aplurality of connected unit cells. Each unit cell may define a unit cellstructure that includes a plurality of lattice struts that define anouter geometric structure and a plurality of internal struts that definea plurality of internal geometric structures that are disposed withinthe outer geometric structure. In one example, the outer geometricstructure may be a rhombic dodecahedron, and the inner geometricstructures may be a rhombic trigonal trapezohedron. It should beappreciated that such geometric structures may be varied to fit theneeds of a given design. Further, it should be appreciated that the unitcells that make up the porous-metal coating 30 may also have anysuitable alternative geometry to fit the needs of a given design.

The porous material of the porous-metal coating 30 is formed from ametal powder. Illustratively, the metal powders may include, but are notlimited to, titanium, titanium alloys, stainless steel, cobalt chromealloys, tantalum, or niobium powders. The porous-metal coating 30 has aporosity suitable to facilitate bony ingrowth into the tibial coneaugment 12 when it is implanted into the surgically-prepared proximalend of the patient's tibia.

In the illustrative embodiment described herein, the porous-metalcoating 30 is additively manufactured directly onto the outer surfacesof the solid-metal base 32. In such an embodiment, the twostructures—i.e., the solid-metal base 32 and the porous-metal coating30—may be manufactured contemporaneously during a common additivemanufacturing process. For example, the two structures may bemanufactured contemporaneously in a single 3D printing operation thatyields a common, monolithic metallic component including bothstructures. Alternatively, the porous-metal coating 30 could bemanufactured as a separate component that is secured to the solid-metalbase 32.

As can be seen in FIGS. 1 and 3 , the inner sidewall 36 that defines thebores 18, 26, 28 of the hollow body 16 has a number of cement pockets 38formed therein. Bone cement is received into the cement pockets 38 toincrease adhesion of the cement to the tibial cone augment 12 duringimplantation of the tibial revision prosthesis.

As shown in FIGS. 8 and 9 , the tibial cone augment 12 may be providedin a number of different configurations to fit the needs of a givenpatient's anatomy. In particular, the tibial cone augment 12 may beconfigured in various different sizes to conform to the patient'sanatomy and/or accommodate a wide range of bone loss. In oneillustrative embodiment, the tibial cone augment 12 may be provided infour different sizes (e.g., Sizes Small (S), Medium (M), Large (L),Extra Large (XL)). As shown in FIG. 8 , the medial/lateral augment widthof the body 16 changes as a function of the size of the tibial coneaugment 12. As used herein, the term “medial/lateral augment width”refers to the width of the augment at its widest medial/lateraldimension. As can be seen in FIG. 8 , the medial/lateral augment width(W_(AugM/L)) of the tibial cone augment 12 increases as the size of thetibial cone augment 12 increases. In other words, a Size M tibial coneaugment 12 has a larger medial/lateral width than a Size S tibial coneaugment 12, but a smaller medial/lateral width than a Size L (or SizeXL) tibial cone augment 12.

However, as shown in FIG. 8 , each of the differently-sized tibial coneaugments 12 has a common taper angle in the medial/lateral direction(i.e., a common medial/lateral augment taper angle). In particular, thecone augment's “medial/lateral augment taper angle” is defined herein asthe magnitude of the angle formed by the entirety of the medial-mostedge 46 and the entirety of the lateral-most edge 48 of the augment. Inother words, the cone augment's “medial/lateral augment taper angle” isdefined as the magnitude of the angle formed by the medial-most edge 46and the lateral-most edge 48 of the augment from the inferior-most end50 of each edge 46, 48 to the superior-most end 52 of each edge 46, 48.As can be seen in FIG. 8 , each of the differently-sized tibial coneaugments 12 has a common medial/lateral augment taper angle(θ_(AugM/L)). In the exemplary embodiment described herein, each of thedifferently-sized tibial cone augments 12 has a medial/lateral augmenttaper angle of 39° (i.e., θ_(AugM/L)=39°.

As shown in FIG. 9 , the anterior/posterior augment depth of the body 16changes as a function of the size of the tibial cone augment 12. As usedherein, the term “anterior/posterior augment depth” refers to the widthof the augment at its widest anterior/posterior dimension. As can beseen in FIG. 9 , the anterior/posterior augment depth (D_(AugA/P)) ofthe tibial cone augment 12 increases as the size of the tibial coneaugment 12 increases. In other words, a Size M tibial cone augment 12has a larger anterior/posterior augment depth than a Size S tibial coneaugment 12, but a smaller anterior/posterior augment depth than a Size L(or Size XL) tibial cone augment 12.

However, as shown in FIG. 9 , each of the differently-sized tibial coneaugments 12 has a common taper angle in the anterior/posterior direction(i.e., a common anterior/posterior augment taper angle). In particular,the cone augment's “anterior/posterior augment taper angle” is definedherein as the magnitude of the angle formed by the entirety of theanterior-most edge 56 and the entirety of the posterior-most edge 58 ofthe augment. In other words, the cone augment's “anterior/posterioraugment taper angle” is the magnitude of the angle formed by theanterior-most edge 56 and the lateral-most edge 58 of the cone augmentfrom the inferior-most end 64 of each edge 56, 58 to the superior-mostend 66 of each edge 56, 58. As can be seen in FIG. 9 , each of thedifferently-sized tibial cone augments 12 has a commonanterior/posterior augment taper angle (θ_(AugA/P)). In the exemplaryembodiment described herein, each of the differently-sized tibial coneaugments 12 has an anterior/posterior augment taper angle of 14° (i.e.,θ_(AugA/P)=14°.

As shown in FIGS. 5-7 , the tibial surgical broach 14 has a geometrythat closely corresponds to the geometry of the tibial cone augment 12.In particular, the tibial surgical broach 14 has body 60 that includes anumber of cutting teeth 62 that are configured to cut and remove bonetissue in a shape that corresponds to the shape of the tibial coneaugment 12. As such, the cutting teeth 62 are arranged in a central lobesection 70, a medial lobe section 72, and a lateral lobe section 74. Aswith the tibial cone augment 12, it should be appreciated that althoughthe tibial surgical broach 14 is herein shown as a tri-lobe tibialsurgical broach (i.e., it has three lobe sections 70, 72, 74), thetibial surgical broach 14 may be embodied as a bi-lobe tibial surgicalbroach (i.e., having a central lobe section 70 and only one of themedial lobe section 72 or the lateral lobe section 74, but not both) ora concentric tibial surgical broach (i.e., having a central lobe section70, but neither the medial lobe section 72 nor the lateral lobe section74).

In the illustrative embodiment described herein, the tibial surgicalbroach 14 is constructed with stainless steel. Other suitable materialsmay be used to fit the needs of a given design of the broach 14.

As shown in FIGS. 10 and 11 , the tibial surgical broach 14 may beprovided in a number of different configurations to correspond to thedifferent configurations of the tibial cone augment 12. In particular,the tibial surgical broach 14 may be configured in various differentsizes to conform to the sizes of the tibial cone augment 12. As such, inone illustrative embodiment, the tibial surgical broach 14 may beprovided in four different sizes (e.g., Sizes Small (S), Medium (M),Large (L), Extra Large (XL)). As shown in FIG. 10 , the medial/lateralbroach width of the body 60 changes as a function of the size of thetibial surgical broach 14. As used herein, the term “medial/lateralbroach width” refers to the width of the broach at its widestmedial/lateral dimension. As can be seen in FIG. 10 , the medial/lateralbroach width (W_(BroM/L)) of the tibial surgical broach 14 increases asthe size of the tibial surgical broach 14 increases. In other words, aSize M tibial surgical broach 14 has a larger medial/lateral broachwidth than a Size S tibial surgical broach 14, but a smallermedial/lateral broach width than a Size L (or XL) tibial surgical broach14.

However, like the tibial cone augment 12 and as shown in FIG. 10 , eachof the differently-sized tibial surgical broaches 14 has a common taperangle in the medial/lateral direction (i.e., a common medial/lateralbroach taper angle). In particular, the surgical broach's“medial/lateral broach taper angle” is defined herein as the magnitudeof the angle formed by the entirety of an imaginary line extending alongand connecting the medial-most edges 76 of the broach's individualcutting teeth 62 and the entirety of an imaginary line extending alongand connecting the lateral-most edges 78 of the broach's individualcutting teeth 62. In other words, the surgical broach's “medial/lateralbroach taper angle” is the magnitude of the angle formed by theimaginary line extending along and connecting the medial-most edges 76of the broach's individual cutting teeth 62 and the imaginary lineextending along and connecting the lateral-most edges 78 of the broach'sindividual cutting teeth 62 from the distal-most end 80 of eachimaginary line to the proximal-most end 82 of each imaginary line.

Moreover, the medial/lateral broach taper angle of the broach 14 is thesame as the medial/lateral augment taper angle of the tibial coneaugment 12. Specifically, the medial/lateral taper angle of the broach14 matches the medial/lateral taper angle of the augment 12. As such andas can be seen in FIGS. 8 and 10 , each of the differently-sized tibialsurgical broaches 14 has a common medial/lateral broach taper angle(θ_(BroM/L)), which is the same as the medial/lateral augment taperangle (θ_(AugM/L)) common to each of the tibial cone augments 12. In theexemplary embodiment described herein, each of the differently-sizedtibial surgical broaches has a medial/lateral broach taper angle of 39°(i.e., θ_(BroM/L)=39°.

As shown in FIG. 11 , the anterior/posterior broach depth of the body 60changes as a function of the size of the tibial surgical broach 14. Asused herein, the term “anterior/posterior broach depth” refers to thewidth of the broach at its widest anterior/posterior dimension. As canbe seen in FIG. 11 , the anterior/posterior broach depth (D_(BroA/P)) ofthe tibial surgical broach 14 increases as the size of the tibialsurgical broach 14 increases. In other words, a Size M tibial surgicalbroach 14 has a larger anterior/posterior broach depth than a Size Stibial surgical broach 14, but a smaller anterior/posterior augmentdepth than a Size L (or Size XL) tibial surgical broach 14.

However, as shown in FIG. 11 , each of the differently-sized tibialsurgical broaches 14 has a common taper angle in the anterior/posteriordirection (i.e., a common anterior/posterior broach taper angle). Inparticular, the tibial surgical broach's “anterior/posterior broachtaper angle” is defined herein as the magnitude of the angle formed bythe entirety of an imaginary line extending along and connecting theanterior-most edges 86 of the broach's individual cutting teeth 62 andthe entirety of an imaginary line extending along and connecting theposterior-most edges 88 of the broach's individual cutting teeth 62. Inother words, the surgical broach's “anterior/posterior broach taperangle” is the magnitude of the angle formed by the imaginary lineextending along and connecting the anterior-most edges 86 of thebroach's individual cutting teeth 62 and the imaginary line extendingalong and connecting the posterior-most edges 88 of the broach'sindividual cutting teeth 62 from the distal-most end 90 of eachimaginary line to the proximal-most end 92 of each imaginary line.

Moreover, the anterior/posterior broach taper angle of the broach 14 isthe same as the anterior/posterior augment taper angle of the tibialaugment component 12. Specifically, the anterior/posterior taper angleof the broach 14 matches the anterior/posterior taper angle of theaugment 12. As such and as can be seen in FIGS. 9 and 11 , each of thedifferently-sized tibial surgical broach's 14 has a commonanterior/posterior broach taper angle (θ_(BroA/P)), which is the same asthe anterior/posterior augment taper angle (θ_(AugA/P)) common to eachof the tibial cone augments 12. In the exemplary embodiment describedherein, each of the differently-sized tibial surgical broaches has ananterior/posterior broach taper angle of 14° (i.e., θ_(BroA/P)=14°.

Referring now to FIGS. 12-21 , the orthopaedic joint replacement system10 also includes a femoral cone augment 112 and a femoral surgicalbroach 114 for use in preparing the bone to receive one of the femoralcone augments 112. The femoral cone augment 112 includes an elongatedhollow body 116 that is open on its anterior side. The bore 118 definedby the hollow body 116 is sized and shaped to receive a femoral stemcomponent of a femoral revision prosthesis (not shown). Moreover, thesize and shape of the bore 118 allow the position of the femoral stemcomponent of the femoral revision prosthesis to be offset in themedial/lateral direction from the center of the augment 112 as needed tofit the needs of a given surgical installation. Moreover, the body 116has a cutout 120 formed in the posterior side of the femoral coneaugment 112. The cutout 120 provides clearance for the box of therevision femoral component.

Like the body 16 of the tibial cone component 12, the body 116 of thefemoral cone augment 112 is illustratively embodied as a solid-metalbase 132 having a porous-metal coating 130 disposed thereon. Thesolid-metal base 132 and the porous-metal coating 130 may be embodiedand manufactured in a similar manner as to the solid-metal base 32 andthe porous metal coating 30 discussed above in regard to the tibial conecomponent 12, with all such features, methods, starting materials, andalternatives not being repeated herein for purposes of brevity. In theillustrative embodiment described herein, like as was described above inregard to the tibial cone augment 12, the porous-metal coating 130 isdisposed on the solid-metal base 132 of the femoral cone augment 112 byvirtue of being additively manufactured contemporaneously with thesolid-metal base 132 so as to create a common, monolithic component ofthe two metal structures.

As can be seen in FIGS. 12 and 13 , the inner sidewall 136 that definesthe bore 118 of the hollow body 116 has a number of cement pockets 138formed therein. Bone cement is received into the cement pockets 138 toincrease adhesion of the cement to the femoral cone augment 112 duringimplantation of the femoral revision prosthesis.

As shown in FIGS. 18 and 19 , like the tibial cone augment 12, thefemoral cone augment 112 may be provided in a number of differentconfigurations to fit the needs of a given patient's anatomy. Inparticular, the femoral cone augment 112 may be configured in variousdifferent sizes to conform to the patient's anatomy and/or accommodate awide range of bone loss. In one illustrative embodiment, the femoralcone augment 112 may be provided in four different sizes (e.g., SizesSmall (S), Medium (M), Large (L), Extra Large (XL)), although othersizes (e.g., Size Double Extra Large (XXL)) could also be provided tofit the needs of a given design of the orthopaedic joint replacementsystem 10. As shown in FIG. 18 , the medial/lateral augment width of thebody 116 changes as a function of the size of the femoral cone augment112. As can be seen in FIG. 18 , the medial/lateral augment width(WAu_(g)M/L) of the femoral cone augment 112 increases as the size ofthe femoral cone augment 112 increases. In other words, a Size M femoralcone augment 112 has a larger medial/lateral width than a Size S femoralcone augment 112, but a smaller medial/lateral width than a Size L (orSize XL) femoral cone augment 112.

However, as also shown in FIG. 18 , like the tibial cone augment 12,each of the differently-sized femoral cone augments 112 has a commontaper angle in the medial/lateral direction (i.e., a commonmedial/lateral augment taper angle). Specifically, each of thedifferently-sized femoral cone augments 112 has a common medial/lateralaugment taper angle (θ_(AugM/L)). In the exemplary embodiment describedherein, each of the differently-sized femoral cone augments 112 has amedial/lateral augment taper angle of 19° (i.e., θ_(AugM/L)=19°.

As shown in FIG. 19 , the anterior/posterior augment depth of the body116 changes as a function of the size of the femoral cone augment 112.In particular, the anterior/posterior augment depth (D_(AugA/P)) of thefemoral cone augment 112 increases as the size of the femoral coneaugment 112 increases. In other words, a Size M femoral cone augment 112has a larger anterior/posterior augment depth than a Size S femoral coneaugment 112, but a smaller anterior/posterior augment depth than a SizeL (or Size XL) femoral cone augment 112.

However, as shown in FIG. 19 , each of the differently-sized femoralcone augments 112 has a common taper angle in the anterior/posteriordirection (i.e., a common anterior/posterior augment taper angle).Specifically, each of the differently-sized femoral cone augments 112has a common anterior/posterior augment taper angle (θ_(AugA/P)). In theexemplary embodiment described herein, each of the differently-sizedfemoral cone augments 112 has an anterior/posterior augment taper angleof 9.5° (i.e., θ_(AugA/P)=9.5°.

As shown in FIGS. 15-17 , the femoral surgical broach 114 has a geometrythat closely corresponds to the geometry of the femoral cone augment112. In particular, the femoral surgical broach 114 has body 160 thatincludes a number of cutting teeth 62 that are configured to cut bonetissue in a shape that corresponds to the shape of the femoral coneaugment 112. Like the tibial surgical broach 14, in the illustrativeembodiment described herein, the femoral surgical broach 114 isconstructed with stainless steel. Other suitable materials may be usedto fit the needs of a given design of the broach 114.

As shown in FIGS. 20 and 21 , the femoral surgical broach 114 may beprovided in a number of different configurations to correspond to thedifferent configurations of the femoral cone augment 112. In particular,the femoral surgical broach 114 may be configured in various differentsizes to conform to the sizes of the femoral cone augment 112. As such,in one illustrative embodiment, the femoral surgical broach 114 may beprovided in four different sizes (e.g., Sizes Small (S), Medium (M),Large (L), Extra Large (XL)), although additional sizes of the femoralsurgical broach 114 (e.g., Size Double Extra Large (XXL)) could also beprovided if the femoral cone augment 112 is provided in such additionalsizes. As shown in FIG. 20 , the medial/lateral broach width of the body160 changes as a function of the size of the femoral surgical broach114. Specifically, as can be seen in FIG. 20 , the medial/lateral broachwidth (W_(BroM/L)) of the femoral surgical broach 114 increases as thesize of the femoral surgical broach 114 increases. In other words, aSize M femoral surgical broach 114 has a larger medial/lateral broachwidth than a Size S femoral surgical broach 114, but a smallermedial/lateral broach width than a Size L (or Size XL) femoral surgicalbroach 114.

However, like the femoral cone augment 112 and as shown in FIG. 20 ,each of the differently-sized femoral surgical broaches 114 has a commontaper angle in the medial/lateral direction (i.e., a commonmedial/lateral broach taper angle). Moreover, the medial/lateral broachtaper angle of the broach 114 is the same as the medial/lateral augmenttaper angle of the femoral cone augment 112. Specifically, themedial/later taper angle of the broach 114 matches the medial/lateraltaper angle of the augment 112. As such and as can be seen in FIGS. 18and 20 , each of the differently-sized tibial surgical broaches 114 hasa common medial/lateral broach taper angle (θ_(BroM/L)), which is thesame as the medial/lateral augment taper angle (θ_(AugM/L)) common toeach of the femoral cone augments 112. In the exemplary embodimentdescribed herein, each of the differently-sized femoral surgicalbroaches 114 has a medial/lateral broach taper angle of 19° (i.e.,θ_(BroM/L)=19°).

As shown in FIG. 21 , the anterior/posterior broach depth of the body160 changes as a function of the size of the femoral surgical broach114. Specifically, the anterior/posterior broach depth (D_(BroA/P)) ofthe femoral surgical broach 114 increases as the size of the femoralsurgical broach 114 increases. In other words, a Size M femoral surgicalbroach 114 has a larger anterior/posterior broach depth than a Size Sfemoral surgical broach 114, but a smaller anterior/posterior augmentdepth than a Size L (or Size XL) femoral surgical broach 114.

However, as shown in FIG. 21 , each of the differently-sized femoralsurgical broaches 114 has a common taper angle in the anterior/posteriordirection (i.e., a common anterior/posterior broach taper angle).Moreover, the anterior/posterior broach taper angle of the broach 114 isthe same as the anterior/posterior augment taper angle of the femoralcone augment 112. Specifically, the anterior/posterior taper angle ofthe broach 114 matches the anterior/posterior taper angle of the augment112. As such and as can be seen in FIGS. 19 and 21 , each of thedifferently-sized tibial surgical broaches 114 has a commonanterior/posterior broach taper angle (θ_(BroA/P)), which is the same asthe anterior/posterior augment taper angle (θ_(AugA/P)) common to eachof the femoral cone augments 112. In the exemplary embodiment describedherein, each of the differently-sized femoral surgical broaches 114 hasan anterior/posterior broach taper angle of 9.5° (i.e., θ_(BroA/P)=9.5°.

As described above, the geometry of the surgical broaches 14, 114closely corresponds to the geometry of the cone augments 12, 112.Specifically, a common medial/lateral taper angle and a commonanterior/posterior taper angle is used between all the different sizesof the tibial surgical broaches 12 and the tibial cone augments 14, witha common medial/lateral taper angle and a common anterior/posteriortaper angle also being used between all the different sizes of thefemoral surgical broaches 112 and the femoral cone augments 114. Such anarrangement provides for enhanced ease of use during performance of anorthopaedic surgical procedure given it provides for enhanced flexiblyin the intra-operative decision making by the surgeon. For example, ifduring the trialing process, the surgeon determines that the patient'sbone was over prepped (i.e., a larger bone cavity was created thanneeded), the surgeon can simply substitute a larger cone augment thanoriginally planned since the augments all “grow” along the same taperangles throughout the range of sizes. Similarly, in the case of when thesurgeon determines that the patient's bone was under prepped (i.e., asmaller bone cavity was created than needed), the surgeon can simplybroach the cavity with the next size up broach. Alternatively, thesurgeon can also substitute a smaller cone augment than originallyplanned and simply allow the smaller cone augment to sit a bit deeper inthe prepared cavity since the cavity has been broached to common taperangles relative to the entire range of augment sizes. Use of a smallercone augment sitting deeper in the cavity may be preferred overre-broaching the cavity to a larger size in the case of when the largerbroach might be less than ideal due to the anatomy of the patient or themagnitude of bone available in one direction or the other (e.g., theamount of bone available in the anterior/posterior direction may belimited even though ample bone exists for the larger broach in themedial/ lateral direction).

As will be described below in greater detail, the surgical broaches 14,114 are used in combination with a stem trial component 150 tosurgically prepare the proximal end of a patient's tibia (in the case ofthe tibial surgical broach 14) or the distal end of the patient's femur(in the case of the femoral surgical broach 114). As used herein, theterm “stem trial component” refers to is an orthopaedic surgicalinstrument for use by a surgeon in trialing or otherwise assessing thefit of an intramedullary stem component during performance anorthopaedic surgical procedure. As such, it should be appreciated that,as used herein, the term “stem trial component” is distinct fromorthopaedic implants or prostheses that are surgically implanted in thebody of the patient or other orthopaedic surgical instruments (such ascanal reamers, intramedullary rods, etcetera) that are used to performother functions during an orthopaedic surgical procedure.

As can be seen in FIGS. 6 and 16 , the surgical broaches 14, 114 have athreaded bore 152 formed in their respective distal ends 154. Thethreaded bore 152 is sized to receive a threaded post 154 formed in theproximal end 156 of the stem trial component 150 (the threaded post 154can be seen, for example, in FIG. 27 ) so as to selectively secure thestem trial component 150 to the broach 14, 114. In such a way, and asdiscussed below in more detail, the stem trial component 150 may be usedas a guide instrument during use of the broach 14, 114. In doing so, thestem trial component 150 provides an enhanced and simplified approach toguiding the broaching process relative to use of heretofore designedsystems which can require complex apparatus to be assembled to the bone.

The stem trial component 150 may also be used to guide a cone reamer 160during a preliminary step in the orthopaedic surgical procedure toimplant the cone augments 12, 112. As shown in FIGS. 22-24 , the conereamer 160 includes an elongated shaft 162 having a proximal end 164that fits into the chuck of a rotary power tool or a manual handle (notshown). The cone reamer 160 also includes a cutting head 166 located atthe opposite, distal end 168 of the shaft 162. The cutting head 166 ofthe cone reamer 160 includes a plurality of helical cutting flutes 170.The cutting head 166 is generally conical in shape. When the cone reamer160 is positioned in the patient's tibia or femur and rotated, thecutting flutes 170 ream or otherwise cut the bone tissue to form asurgically-prepared cavity to accommodate the geometry of one of thebroaches 14, 114. As such, the cone reamer 160 may be used to form aninitial surgically-prepared cavity in the patient's bone, with one ofthe broaches 14, 114 then being used to form the final shape and size ofthe surgically-prepared cavity.

As shown in FIGS. 22 and 24 , the cone reamer 160 has a threaded bore172 formed in its distal end 168. Like the threaded bores 152 formed inthe broaches 14, 114, the threaded bore 172 of the reamer 160 is sizedto receive the threaded post 154 formed in the proximal end 156 of thestem trial component 150 so as to selectively secure the stem trialcomponent 150 to the cone reamer 160. In such a way, and as discussedbelow in more detail, the stem trial component 150 may be used as aguide instrument during use of the cone reamer 160. Like the surgicalbroaches 14, 114, in the illustrative embodiment described herein, thecone reamer 160 is constructed with stainless steel. Other suitablematerials may be used to fit the needs of a given design of the reamer160.

As described above, the orthopaedic system 10 may be used tosurgically-prepare a patient's knee to receive a revision kneeprosthesis. In particular, as shown in FIGS. 25-31 , the orthopaedicsystem 10 may be used to surgically prepare a patient's tibia 200 toreceive a revision tibial prosthesis. As shown in FIGS. 32-36 , theorthopaedic system 10 may also be used to surgically prepare a patient'sfemur 250 to receive a revision femoral prosthesis.

As shown in FIG. 25 , the orthopaedic system 10 is used in a revisionprocedure in which a primary tibial implant has been removed from theproximal end 202 of the patient's tibia 200. As shown in FIG. 25 , in arevision procedure, the proximal end 202 of the patient's tibia 200includes a plurality of surfaces that had been previouslysurgically-shaped to receive the primary implant. During a revisionprocedure, the proximal end 202 of the patient's tibia 200 is furthersurgically-resected to prepare the bone to receive a revision tibialprosthesis. FIGS. 25-31 illustrate a number of exemplary steps of aprocedure for surgically-preparing the proximal end 202 of the patient'stibia 200 during a revision procedure. It should be appreciated that anysurgical procedure may include additional or fewer steps depending onthe state of the patient's bony anatomy and the preferences of thesurgeon.

Referring specifically now to FIG. 25 , the proximal end 202 of thepatient's tibia 200 includes an opening 206 defined in a planar resectedsurfaces 204. The opening 206 was formed during the previous procedureto implant the primary implant and now permits the surgeon to access theintramedullary canal 208 of the patient's tibia subsequent to removal ofthe primary implant. With access to the intramedullary canal 208 nowachieved, the surgeon then prepares the intramedullary canal 208 of thepatient's tibia 200 to receive the stem of a revision tibial prosthesis.To do so, as shown in FIG. 26 , the surgeon uses a canal reamer 210 toream the portion of the patient's intramedullary canal 208 into whichthe stem component of the tibial revision prosthesis is implanted. To doso, the surgeon inserts the proximal end of the canal reamer 210 intothe chuck of the manual handle or a rotary power tool. The surgeon thenpositions the cutting head 216 of the canal reamer 210 in theintramedullary canal 208 of the patient's tibia 200 and thereafterrotates the cutting head 216 manually (by use of a handle) or under thecontrol of a rotary power tool. Such rotation of the cutting head 216causes its cutting flutes 218 to ream or otherwise cut the bone tissueof the tibia 200. The canal reamer 210 is driven to a desired depth andthen removed.

The surgeon then prepares the proximal end 202 of the patient's tibia200 to receive one of the tibial cone augments 12. To do so, the surgeonfirst reams a starter cavity 220 in the proximal end 202 of thepatient's tibia 200. As shown in FIGS. 27 and 28 , the surgeon installsthe stem trial component 150 on the cone reamer 160 by threading thestem's threaded post 154 into the threaded bore 172 formed in the distalend 168 of the reamer 160. It should be appreciated that the surgeonselects a stem trial component 150 that has a diameter that closelymatches the diameter of the canal reamer 210 previously used to ream thepatient's intramedullary canal 208 such that the stem trial component150 forms a substantially tight fit within the reamed canal 208. In sucha way, the stem trial component 150 is tightly captured within thereamed intramedullary canal 208 and, as a result, functions as a guideinstrument for the cone reamer 160 so as to maintain the rotary axis ofthe reamer 160 in alignment with the center of the reamed intramedullarycanal 208.

With the stem trial component 150 attached to the cone reamer 160, thesurgeon inserts the proximal end of the cone reamer 160 into the chuckof the manual handle or a rotary power tool. The surgeon then advancesthe distal end 158 of the stem trial component 150 into theintramedullary canal 208 of the patient's tibia 200 and thereafterrotates the cutting head 166 (and hence the stem trial component 150secured thereto) manually (by use of a handle) or under the control of arotary power tool. Such rotation of the cutting head 166 causes itscutting flutes 170 to ream or otherwise cut the bone tissue of theproximal end 202 of the tibia 200 so as to form a reamed starter cavity220 therein. The cone reamer 160 is driven to a desired depth -typically when the proximal end of the reamer's cutting head 166 isflush with the planar surface 204 of the proximal end 202 of the tibia200 - and is thereafter removed.

The surgeon then broaches a finished cavity 222 in the proximal end 202of the patient's tibia 200. As shown in FIGS. 29 and 30 , the surgeoninstalls the stem trial component 150 on the tibial surgical broach 14by threading the stem's threaded post 154 into the threaded bore 152formed in the distal end 154 of the tibial surgical broach 14. It shouldbe appreciated that because the stem trial component 150 has a diameterthat closely matches the diameter of the canal reamer 210, and thus istightly captured within the reamed intramedullary canal 208, the stemtrial component 150 functions a guide instrument for the tibial surgicalbroach 14 by maintaining the center of the broach's central lobe section70 in alignment with the center of the reamed intramedullary canal 208.

With the stem trial component 150 attached to the tibial surgical broach14, the surgeon then advances the distal end 158 of the stem trialcomponent 150 into the intramedullary canal 208 of the patient's tibia200. The surgeon continues to advance the broach 14 such that itscutting teeth 62 broach or otherwise cut the bone tissue of the proximalend 202 of the tibia 200 into a shape that corresponds to the shape ofthe tibial cone augment 12 so as to form the broached finished cavity222 therein. Thereafter, the broach 14 and stem trial component 150 areremoved.

Once the finished cavity 222 has been broached, the tibial cone augment12 is implanted, as shown in FIG. 31 . As discussed above, if thesurgeon determines that the patient's bone was over prepped (i.e., alarger finished cavity 222 was created than needed), the surgeon cansimply substitute a larger tibial cone augment 12 than originallyplanned since the augments all “grow” along the same taper anglesthroughout the range of sizes. Similarly, in the case of when thesurgeon determines that the patient's bone was under prepped (i.e., asmaller finished cavity 222 was created than needed), the surgeon cansimply broach the cavity with the next size up broach 14. Alternatively,the surgeon can also substitute a smaller tibial cone augment 12 thanoriginally planned and simply allow the smaller cone augment to sit abit deeper in the prepared finished cavity 222 since the cavity 222 hasbeen broached to common taper angles relative to the entire range oftibial cone augment sizes. Use of a smaller tibial cone augment 12sitting deeper in the cavity 222 may be preferred over re-broaching thecavity to a larger size in the case of when the larger broach might beless than ideal due to the anatomy of the patient's tibia 200 or themagnitude of bone available in one direction or the other (e.g., theamount of bone available in the anterior/posterior direction may belimited even though ample bone exists for the larger broach in themedial/ lateral direction).

Once the surgeon has implanted the desired size of the tibial coneaugment 12, the surgeon may then implant a revision tibial prosthesis byinstalling its stem component through the tibial cone augment andthereafter cementing it in place within the bone.

As illustrated in FIGS. 32-36 , the orthopaedic system 10 may also beused to surgically prepare a patient's femur 300 to receive a revisionfemoral prosthesis. As shown in FIG. 32 , the orthopaedic system 10 isused in a revision procedure in which a primary femoral implant has beenremoved from the distal end 302 of the patient's femur 300. In a femoralrevision procedure, the distal end 302 of the patient's femur 300includes a plurality of surfaces that had been previouslysurgically-shaped to receive the primary implant. During a revisionprocedure, the distal end 302 of the patient's femur 300 is furthersurgically-resected to prepare the bone to receive a revision femoralprosthesis. FIGS. 32-36 illustrate a number of exemplary steps of aprocedure for surgically-preparing the distal end 302 of the patient'sfemur 300 during a revision procedure. It should be appreciated that anysurgical procedure may include additional or fewer steps depending onthe state of the patient's bony anatomy and the preferences of thesurgeon.

Referring now to FIG. 32 , the distal end 302 of the patient's femur 300includes an opening 306 defined in the resected surfaces 304. Theopening 306 was formed during the previous procedure to implant theprimary implant and now permits the surgeon to access the intramedullarycanal 308 of the patient's femur subsequent to removal of the primaryimplant. With access to the intramedullary canal 308 achieved, thesurgeon then prepares the intramedullary canal 308 of the patient'sfemur 300 to receive the stem of a revision femoral prosthesis. To doso, as shown in FIG. 33 , the surgeon uses the canal reamer 210 to reamthe portion of the patient's intramedullary canal 308 into which thestem component of the femoral revision prosthesis is implanted. Itshould be appreciated that the canal reamer 210 used by the surgeon toream the femur 300 may, in practice, be embodied differently than thecanal reamer 210 used to ream the patient's tibia 200. In any event, thesurgeon inserts the proximal end of the canal reamer 210 into the chuckof the manual handle or a rotary power tool. The surgeon then positionsthe cutting head 216 of the canal reamer 210 in the intramedullary canal308 of the patient's femur 300 and thereafter rotates the cutting head216 manually (by use of a handle) or under the control of a rotary powertool. Such rotation of the cutting head 216 causes its cutting flutes218 to ream or otherwise cut the bone tissue of the femur 300. The canalreamer 210 is driven to a desired depth and then removed.

The surgeon then prepares the distal end 302 of the patient's femur 300to receive one of the femoral cone augments 112. To do so, the surgeonfirst reams a starter cavity 320 in the distal end 302 of the patient'sfemur 300. As shown in FIG. 34 , the surgeon installs the stem trialcomponent 150 on the cone reamer 160 by threading the stem's threadedpost 154 into the threaded bore 172 formed in the distal end 168 of thereamer 160. It should be appreciated that the surgeon selects a stemtrial component 150 that has a diameter that closely matches thediameter of the canal reamer 210 previously used to ream the patient'sintramedullary canal 308 such that the stem trial component 150 forms asubstantially tight fit within the reamed canal 308. In such a way, thestem trial component 150 is tightly captured within the reamedintramedullary canal 308 and, as a result, functions as a guideinstrument for the cone reamer 160 so as to maintain the rotary axis ofthe reamer 160 in alignment with the center of the reamed intramedullarycanal 308.

With the stem trial component 150 attached to the cone reamer 160, thesurgeon inserts the proximal end of the cone reamer 160 into the chuckof the manual handle or a rotary power tool. The surgeon then advancesthe distal end 158 of the stem trial component 150 into theintramedullary canal 308 of the patient's femur 300 and thereafterrotates the cutting head 166 (and hence the stem trial component 150secured thereto) manually (by use of a handle) or under the control of arotary power tool. Such rotation of the cutting head 166 causes itscutting flutes 170 to ream or otherwise cut the bone tissue of thedistal end 302 of the femur 300 so as to form a reamed starter cavity320 therein. The cone reamer 160 is driven to a desired depth and isthereafter removed.

The surgeon then broaches a finished cavity 322 in the distal end 302 ofthe patient's femur 300. As shown in FIGS. 35 , the surgeon installs thestem trial component 150 on the femoral surgical broach 114 by threadingthe stem's threaded post 154 into the threaded bore 152 formed in thedistal end 154 of the femoral surgical broach 114. It should beappreciated that because the stem trial component 150 has a diameterthat closely matches the diameter of the canal reamer 210, and thus istightly captured within the reamed intramedullary canal 308, the stemtrial component 150 functions a guide instrument for the femoralsurgical broach 114 by maintaining the broach in a desired alignmentrelative to the center of the reamed intramedullary canal 308.

With the stem trial component 150 attached to the femoral surgicalbroach 114, the surgeon then advances the distal end 158 of the stemtrial component 150 into the intramedullary canal 308 of the patient'sfemur 300. The surgeon continues to advance the broach 114 such that itscutting teeth 62 broach or otherwise cut the bone tissue of the distalend 302 of the femur 300 into a shape that corresponds to the shape ofthe femoral cone augment 112 thereby forming the broached finishedcavity 322. Thereafter, the broach 114 and stem trial component 150 areremoved.

Once the finished cavity 322 has been broached, the femoral cone augment112 is implanted, as shown in FIG. 36 . As discussed above, if thesurgeon determines that the patient's bone was over prepped (i.e., alarger finished cavity 322 was created than needed), the surgeon cansimply substitute a larger femoral cone augment 112 than originallyplanned since the augments all “grow” along the same taper anglesthroughout the range of sizes. Similarly, in the case of when thesurgeon determines that the patient's bone was under prepped (i.e., asmaller finished cavity 322 was created than needed), the surgeon cansimply broach the cavity with the next size up broach 114.Alternatively, the surgeon can also substitute a smaller femoral coneaugment 112 than originally planned and simply allow the smaller coneaugment to sit a bit deeper in the prepared finished cavity 322 sincethe cavity 322 has been broached to common taper angles relative to theentire range of femoral cone augment sizes. Use of a smaller femoralcone augment 112 sitting deeper in the cavity 322 may be preferred overre-broaching the cavity to a larger size in the case of when the largerbroach might be less than ideal due to the anatomy of the patient'sfemur 300 or the magnitude of bone available in one direction or theother (e.g., the amount of bone available in the anterior/posteriordirection may be limited even though ample bone exists for the largerbroach in the medial/ lateral direction).

Once the surgeon has implanted the desired size of the femoral coneaugment 112, the surgeon may then implant a revision femoral prosthesisby installing its stem component through the femoral cone augment andthereafter cementing it in place within the bone.

Referring now to FIGS. 37-41 , there is shown another embodiment of atibial cone augment. In particular, there is shown a modular tibial coneaugment 400. Like the other tibial cone augments 12 described herein,the modular tibial cone augment 400 is configured to be implanted into asurgically-prepared cavity in the proximal end of the tibia of a patientso as to facilitate implantation of a revision tibial prosthesis.

The modular tibial cone augment 400 includes separate components whichmay be assembled to one another in various arrangements to create animplant of a desired configuration. In particular, the modular tibialcone augment 400 includes a central lobe component 402, a medial lobecomponent 404, and a lateral lobe component 406. In such a way, themodular tibial cone augment 400 may be assembled as a tri-lobe tibialaugment (i.e., it has all three lobe components 402, 404, 406), abi-lobe tibial augment (i.e., it has a central lobe component 402 andonly one of the medial lobe component 404 or the lateral lobe component406, but not both) or a concentric tibial augment (i.e., it has acentral lobe component 402, but neither the medial lobe component 404nor the lateral lobe component 406).

As shown in FIG. 37 , the central lobe component 402 includes a round,concentrically-shaped elongated hollow body 416 that is tapereddownwardly from its superior end 420 to its inferior end 422. Thecentral lobe component 402 also includes a bore 418 extendingtherethrough in the superior/inferior direction. The bore 418 is sizedand shaped to receive a tibial stem component of a tibial revisionprosthesis. As can be seen in FIG. 37 , the body 416 of the central lobecomponent 402 has a cutout 424 formed on both its medial side 426 andits lateral side 428. The cutouts 424 allow for receipt of structures onthe inferior side of a revision tibial tray such as one or more keels.

As shown in FIGS. 38 and 39 , both of the medial lobe component 404 andthe lateral lobe component 406 have a body 430 that includes a curvedinner sidewall 432 that corresponds in shape to the outer surface of thecentral lobe component 402. As such, when it is secured to the centrallobe component 402, the inner sidewall 432 of the medial lobe component404 corresponds in shape with the medial side 426 of the central lobecomponent's body 416. Similarly, when it is secured to the central lobecomponent 402, the inner sidewall 432 of the lateral lobe component 406corresponds in shape with the lateral side 428 of the central lobecomponent's body 416. As can be seen in FIGS. 38-40 , the medial lobecomponent 404 and the lateral lobe component 406 include a curved outersurface 434 that tapers downwardly from the component's superior end 436to its inferior end 438. In such a way, the inferior end 438 of the sidecomponents 404, 406 blends into the outer surface of the central lobecomponent 402 when secured thereto.

It should be appreciated that the side lobe components 404, 406 may beprovided in a wide variety of geometries. In particular, the side lobecomponents 404, 406 may be provided in a wide range of widths, lengths,curvatures, etcetera to produce a wide range of options for a surgeon tocustomize the geometry of an assembled modular tibial cone augment 400.In such a way, the surgeon can use the modular tibial cone augment 400to accommodate varying degrees of bone loss and/or varying patientanatomies

The surface defining the superior end 436 of both the medial lobecomponent 404 and the lateral lobe component 406 has a recess 440 formedtherein. As can be seen in FIGS. 40 and 41 , the recesses 440 align withthe cutouts 424 formed in the central lobe component 402 when either orboth of the medial lobe component 404 and the lateral lobe component 406are secured to the central lobe component 402. The recesses 440cooperate with the cutouts 424 to allow for receipt of structures on theinferior side of a revision tibial tray such as one or more keels.

As can be seen in FIG. 37 , the central lobe component 402 has aconnector 450 formed on both its medial side 426 and its lateral side428. The connectors 450 mate with connectors 460 formed in the mediallobe component 404 and the lateral lobe component 406 to allow one orboth of the components 404, 406 to be secured to the central lobecomponent 402 during assembly of the modular tibial cone augment 400. Inthe illustrative embodiment described herein, the connectors 450, 460define a dovetail joint. In such a way, the connectors 460 are embodiedas a pair of dovetail-type tabs 462 that are received into acorresponding pair of dovetail-type slots 452 that embody the connectors450 of the central lobe component 402. The tabs 462 and the slots 452taper downwardly from their superior ends to their inferior ends. Assuch, a taper lock is created as the tabs 462 are advanced into theslots 452 thereby locking the components 404, 406 to the central lobecomponent 402. The radial distance between each of the pair of tabs 462on the medial lobe component 404 is the same as the radial distancebetween each of the pair of tabs 462 on the lateral lobe component 406.As such, the side lobe components 404, 406 may, in practice, beinstalled on either side of the central lobe component 402. Thisenhances the flexibility of the modular tibial cone augment 400 sinceits side lobe components are interchangeable with one another and thusany of its side lobe components may be secured to either side of itscentral lobe component 402.

Like the body 16 of the tibial cone component 12 and the body 116 of thefemoral cone augment 112 discussed above, the bodies 416, 430 of thelobe components 402, 404, 406 of the modular tibial cone augment 400 areillustratively embodied as a solid-metal base 472 having a porous-metalcoating 470 disposed thereon. The solid-metal base 472 and theporous-metal coating 470 may be embodied and manufactured in a similarmanner as the solid-metal base 32 and the porous metal coating 30discussed above in regard to the tibial cone component 12, with all suchfeatures, methods, starting materials, and alternatives not beingrepeated herein for purposes of brevity. In the illustrative embodimentdescribed herein, like as was described above in regard to the tibialcone augment 12, the porous-metal coating 470 is disposed on thesolid-metal base 472 of the lobe components 402, 404, 406 by virtue ofbeing additively manufactured contemporaneously with the solid-metalbase 472 so as to create a common, monolithic component of the two metalstructures.

As can be seen in FIGS. 37, 40, and 41 , the inner sidewall 476 thatdefines the bore 418 of the hollow body 416 has a number of cementpockets 478 formed therein. Bone cement is received into the cementpockets 478 to increase adhesion of the cement to the modular tibialcone augment 400 during implantation of the tibial revision prosthesis.

In use, the modular tibial cone augment 400 may be used by a surgeonduring a surgical procedure to implant a tibial revision prosthesis.During such a procedure, the surgeon will assess the patient's bone.Specifically, the surgeon will determine the condition of bone tissue ofthe proximal end of the patient's tibia. From there, the surgeon candetermine the size and type of cone augment that is needed - e.g., aconcentric, bi-lobe, or tri-lobe cone augment. The surgeon then forms asurgically-prepared cavity in the proximal end of the tibia of the tibiaof the patient that corresponds to the size and type of tibial coneaugment to be implanted.

The surgeon may then assemble a modular tibial cone augment 400 thatcorresponds to the shape of the surgically-prepared cavity by locking aselected medial lobe component 404 or a selected lateral lobe component406 —or both—to a selected central lobe component 402 so as to assemblea desired size and configuration of the tibial cone augment to beimplanted. As discussed above, to fit the needs of a given surgicalapplication, the modular tibial cone augment 400 may be assembled as atri-lobe tibial augment (i.e., it has all three lobe components 402,404, 406), a bi-lobe tibial augment (i.e., it has a central lobecomponent 402 and only one of the medial lobe component 404 or thelateral lobe component 406, but not both) or a concentric tibial augment(i.e., it has a central lobe component 402, but neither the medial lobecomponent 404 nor the lateral lobe component 406). Moreover, each of thecomponents 402, 404, 406 may be provided in a range of shapes and sizesto increase the surgeon's options.

Once the desired arrangement of the modular tibial cone augment 400 hasbeen assembled, the surgeon may then install the assembled construct inthe surgically-prepared cavity formed in the proximal end of the tibia.

As can be seen in FIGS. 42-45 , the femoral cone augment 112 has a pairof impact lugs 122, 124 secured to the inner sidewall 136 that definesthe bore 118 of the augment's hollow body 116. The impact lugs 122, 124are secured to opposite sides of the inner sidewall 136. Specifically,in the illustrative embodiment described herein, the medial impact lug122 is secured to a medial side of the inner sidewall 136 and thelateral impact lug 124 is secured to the lateral side of the innersidewall 136.

As can be seen in FIGS. 43 and 44 , the impact lugs 122, 124 extendinwardly from the inner sidewall 136 toward a central axis 110 of theaugment's bore 118. Moreover, each of the impact lugs 122, 124 has aflat, inferior-most impact surface 126. As will be discussed below inmore detail, the impact surfaces 126 of the impact lugs 122, 124 areused during installation of the femoral cone augment 112 into thepatient's knee. As can be seen best in FIGS. 42 and 45 , the impact lugs122, 124 include a curved outer body 128 that extends superiorly fromthe lug's impact surface 126. The curved outer body 128 of the impactlugs 122, 124 is tapered along its length in the superior/inferiordirection such that its superior end 134 blends into the augment's innersidewall 136, as shown in FIGS. 42 and 45 .

As can be seen best in FIGS. 42, 44, and 45 , the impact lugs 122, 124are positioned within the bore 118 of the femoral cone augment's hollowbody 116. In particular, the impact lugs 122, 124 are positioned atlocation between the superior end 140 and the inferior end 142 of theaugment's hollow body 116. In such a way, the impact surfaces 126 of theimpact lugs 122, 124 are spaced apart inferiorly from the body'ssuperior end 140 and superiorly from the body's inferior end 142. In theillustrative embodiment described herein, the superior end 134 of eachof the impact lugs 122, 124 is spaced apart inferiorly from the superiorend 140 of the hollow body 116.

As can be seen best in FIGS. 42-44 , the box cutout 120 formed in theposterior side of the femoral cone augment 112 is defined by a flat,inferior-facing surface 146 and a pair of opposed side surfaces 148. Aswill be discussed below in greater detail, the flat, inferior-facingsurface 146 of the box cutout 120 defines an impact surface that, alongwith the impact surfaces 126 of the impact lugs 122, 124, is contactedby an impactor head to install the femoral cone augment 112.

In the illustrative embodiment described herein, the impact surfaces 126of the impact lugs 122, 124 are coplanar. In particular, as can be seenin FIG. 44 , the impact surfaces 126 of the impact lugs 122, 124 lie ona common plane 108 extending in the medial/lateral direction. As can beseen in FIGS. 44 and 45 , in the illustrative embodiment describedherein, the inferior-facing impact surface 146 of the box cutout 120 iscoplanar with the impact surfaces 126 of the impact lugs 122, 124. Assuch, the inferior-facing impact surface 146 of the box cutout 120 alsolies on the plane 108.

Referring now to FIGS. 46-49 , there is shown a knee cone trialcomponent 500, specifically a femoral cone trial component 512. As usedherein, the term “knee cone trial component” refers to is an orthopaedicsurgical instrument for use by a surgeon in trialing or otherwiseassessing the fit of a knee cone augment during performance anorthopaedic surgical procedure. As such, it should be appreciated that,as used herein, the term “knee cone trial component” is distinct fromorthopaedic implants or prostheses that are surgically implanted in thebody of the patient or other orthopaedic surgical instruments (such ascanal reamers, intramedullary rods, etcetera) that are used to performother functions during an orthopaedic surgical procedure. The term“femoral cone trial component” refers to a knee cone trial componentthat is sized and shaped to mimic a femoral cone augment such as thefemoral cone augment 112.

Because the femoral cone trial component 512 is designed to mimic thefemoral cone augment 112, it possesses a similar structure as theaugment 112. Specifically, as can be seen in FIGS. 46-49 , the femoralcone trial component 512 includes an elongated hollow body 516 that isopen on its anterior side. The bore 518 defined by the hollow body 516is sized and shaped to receive a femoral trial stem component of afemoral revision trial prosthesis (not shown). Moreover, the size andshape of the bore 518 allow the position of the femoral stem trialcomponent of the femoral revision trial prosthesis to be offset in themedial/lateral direction from the center of the femoral cone trialcomponent 512 as needed to fit the needs of a given surgicalinstallation. Moreover, the body 516 has a cutout 520 formed in theposterior side of the femoral cone trial component 512. The cutout 520provides clearance for the box of the revision femoral trial component.

Like the femoral cone augment 112, the femoral cone trial component 512has a pair of impact lugs 522, 524 secured to the inner sidewall 536that defines the bore 518 of the trial component's hollow body 516. Theimpact lugs 522, 524 are secured to opposite sides of the inner sidewall536. Specifically, in the illustrative embodiment described herein, themedial impact lug 522 is secured to a medial side of the inner sidewall536 and the lateral impact lug 524 is secured to the lateral side of theinner sidewall 536.

As can be seen in FIG. 47 , the impact lugs 522, 524 extend inwardlyfrom the inner sidewall 536 toward a central axis 510 of the trialcomponent's bore 518. Moreover, each of the impact lugs 522, 524 has aflat, inferior-most impact surface 526. As will be discussed below inmore detail, the impact surfaces 526 of the impact lugs 522, 524 areused during installation of the femoral cone trial component 512 intothe patient's knee. As can be seen best in FIGS. 46 and 48 , the impactlugs 522, 524 include a curved outer body 528 that extends superiorlyfrom the lug's impact surface 526. The curved outer body 528 of theimpact lugs 522, 524 is tapered along its length in thesuperior/inferior direction such that its superior end 534 blends intothe trial component's inner sidewall 536, as shown in FIG. 48 .

As can be seen best in FIGS. 46-48 , the impact lugs 522, 524 arepositioned within the bore 518 of the femoral cone trial component'shollow body 516. In particular, the impact lugs 522, 524 are positionedat location between the superior end 540 and the inferior end 542 of theaugment's hollow body 516. In such a way, the impact surfaces 526 of theimpact lugs 522, 524 are spaced apart inferiorly from the body'ssuperior end 540 and superiorly from the body's inferior end 542. In theillustrative embodiment described herein, the superior end 534 of eachof the impact lugs 522, 524 is spaced apart inferiorly from the superiorend 540 of the hollow body 516.

As can be seen best in FIGS. 46 and 47 , the box cutout 520 formed inthe posterior side of the femoral cone trial component 512 is defined bya flat, inferior-facing surface 546 and a pair of opposed side surfaces548. As will be discussed below in greater detail, the flat,inferior-facing surface 546 of the box cutout 520 defines an impactsurface that, along with the impact surfaces 526 of the impact lugs 522,524, is contacted by an impactor head to install the femoral cone trialcomponent 512.

In the illustrative embodiment described herein, the impact surfaces 526of the impact lugs 522, 524 are coplanar. In particular, the impactsurfaces 526 of the impact lugs 522, 524 lie on a common plane 508extending in the medial/lateral direction. As can be seen in FIG. 48 ,in the illustrative embodiment described herein, the inferior-facingimpact surface 546 of the box cutout 520 is coplanar with the impactsurfaces 526 of the impact lugs 522, 524. As such, the inferior-facingimpact surface 546 of the box cutout 520 also lies on the plane 508.

Like the other orthopaedic surgical instruments discussed above, in theillustrative embodiment described herein, the femoral cone trialcomponent 512 is constructed with stainless steel. Other suitablematerials may be used to fit the needs of a given design of the femoralcone trial component 512.

Referring now to FIGS. 50-52 , there is shown an impactor head 600 thatis configured to impact the femoral cone augment 112 and the femoralcone trial component 512 during installation of the augment 112 and thetrial component 512 into the patient's knee. A proximal surface 604 ofthe body 602 of the impactor head 600 is configured to be secured to animpaction handle. In the illustrative embodiment described herein, theproximal surface 604 includes a connector 606 for connecting theimpactor head 600 to a removable impaction handle 950 (see FIG. 83 ). Itshould be appreciated; however, that in other embodiments the proximalsurface 604 may also be secured to an integrated, non-removableimpaction handle. The connector 606 includes a D-shaped socket 608formed in the proximal surface 604 of the impactor head 600. TheD-shaped socket 608 is sized, shaped, and positioned to receive aD-shaped connecting pin 952 of the connector 954 of the impaction handle950 (see FIG. 83 ). The connector 606 of the impactor head 600 alsoincludes a connector lip 610. When the impaction handle's connecting pin952 is inserted in the D-shaped socket 608 of the impactor head 600 andthereafter advanced downwardly, the connector lip 610 is engaged by alocking pawl 956 of the impaction handle's connector 954 (see FIG. 53 )to secure the impactor head 600 to the impaction handle 950.

Opposite the proximal surface 604, the body 602 of the impactor head 600includes an impact surface 616. The impact surface 616 has a pair ofimpact shoulders 622, 624 formed therein. The impact shoulders 622, 624are formed in opposite sides of the body 602 of the impactor head 600.Specifically, in the illustrative embodiment described herein, themedial impact shoulder 622 is formed in a medial side of the body 602 ofthe impactor head 600 and the lateral impact shoulder 624 is formed inthe lateral side of the body 602 of the impactor head 600. Each of theimpact shoulders 622, 624 has a flat impact surface 626 that defines theblind proximal end of a guide slot 628. As shown in FIGS. 54-56 , theimpact surfaces 626 are sized and shaped to be positioned on the impactsurfaces 126 of the impact lugs 122, 124 when the impactor head 600 isused during installation of the femoral cone augment 112 into thepatient's knee. Similarly, as shown in FIGS. 57-59 , the impact surfaces626 are also sized and shaped to be positioned on the impact surfaces526 of the impact lugs 522, 524 when the impactor head 600 is usedduring installation of the femoral cone trial component 512 into thepatient's knee.

The impact surface 616 also has an impact lip 630 formed therein. Theimpact lip 630 has a flat impact surface 632 facing the same directionas the impact surfaces 626 of the impactor head's impact shoulders 622,624. As shown in FIGS. 54-56 , the impact surface 632 of the impact lip630 is sized and shaped to be positioned on the flat, inferior-facingsurface 146 of the box cutout 120 of the femoral cone augment 112 whenthe impactor head 600 is used during installation of the femoral coneaugment 112 into the patient's knee. Similarly, as shown in FIGS. 57-59, the impact surface 632 of the impact lip 630 is also sized and shapedto be positioned on the flat, inferior-facing surface 546 of the boxcutout 520 of the femoral cone trial component 512 when the impactorhead 600 is used during installation of the femoral cone trial component512 into the patient's knee.

In the illustrative embodiment described herein, the impact surfaces 626of the impact shoulders 622, 624 are coplanar. In particular, the impactsurfaces 626 of the impact shoulders 622, 624 lie on a common plane 618extending in the medial/lateral direction. As can be seen in FIG. 51 ,in the illustrative embodiment described herein, the flat impact surface632 of the impact lip 630 is coplanar with the impact surfaces 626 ofthe impact shoulders 622, 624. As such, the impact surface 632 of theimpact lip 630 also lies on the plane 618.

Like the surgical broaches 14, 114, in the illustrative embodimentdescribed herein, the impactor head 600 is constructed with stainlesssteel. Other suitable materials may be used to fit the needs of a givendesign of the impactor head 600.

Moreover, the impactor head 600 may be provided in a number of differentconfigurations to correspond to the different configurations of thefemoral cone augment 112 and the femoral cone trial component 512. Inparticular, the impactor head 600 may be configured in various differentsizes to conform to the sizes of the femoral cone augment 112 and thefemoral cone trial component 512. As such, in one illustrativeembodiment, the impactor head 600 may be provided in four differentsizes (e.g., Sizes Small (S), Medium (M), Large (L), Extra Large (XL)),although additional sizes of the impactor head 600 (e.g., Size DoubleExtra Large (XXL)) could also be provided if the femoral cone augment112 and the femoral cone trial component 512 are provided in suchadditional sizes.

As can be seen in FIG. 53 , the impactor head 600 may be used duringinstallation of the femoral cone augment 112 in a revision procedure inwhich a primary femoral implant has been removed from the distal end 302of the patient's femur 300. The impactor head 600 may also be used toinstall the femoral cone trial component 512 during such a revisionprocedure. Prior to installation of either femoral cone augment 112 orthe femoral cone trial component 512, the cavity 322 to receive thefemoral cone augment 112 (or trial component 512) is firstsurgically-prepared in the distal end 302 of the patient's femur 300.The method described above in regard to FIGS. 32-36 may be used as aprocedure for surgically-preparing the distal end 302 of the patient'sfemur 300 in such a manner. However, it should be appreciated that sucha surgical procedure may include additional, fewer, or alternate stepsdepending on the state of the patient's bony anatomy and the preferencesof the surgeon.

Once the surgically-prepared cavity 322 has been formed in the distalend 302 of the patient's femur 300, the surgeon positions a femoral coneaugment 112 of the appropriate size in the cavity 322. Thereafter, thesurgeon utilizes the impactor head 600 to impact the femoral coneaugment 112. To do so, the surgeon first connects an impactor head 600corresponding in size to femoral cone augment 112 being installed to theimpaction handle 950. Specifically, the impaction handle's connectingpin 952 (see FIG. 83 ) is inserted in the D-shaped socket 608 of theimpactor head 600 and thereafter advanced downwardly such that theconnector lip 610 of the impactor head 600 is then engaged by thelocking pawl 956 of the impaction handle's connector 954 to secure theimpactor head 600 to the impaction handle 950.

The surgeon then utilizes the impaction handle 950 to advance the distalend of the impactor head 600 into the bore 118 of the femoral coneaugment 112 positioned in the distal end 302 of the patient's femur 300.As the impactor head 600 is advanced into the femoral cone augment'sbore 118, the augment's impact lugs 122, 124 are captured in theimpactor head's guide slots 628. Specifically, the medial impact lug 122is captured in the guide slot 628 on the medial side of the impactorhead 600 and the lateral impact lug 124 is captured in the guide slot628 on the lateral side of the impactor head 600. The surgeon advancesthe impactor head 600 to a seated position in which the impact surfaces626 of the impact shoulders 622, 624 are positioned in contact with theimpact surfaces 126 of the augment's impact lugs 122, 124, respectively,as shown in FIG. 55 . Doing so also positions the impact surface 632 ofthe impact lip 630 into contact with the flat, inferior-facing surface146 of the box cutout 120 of the femoral cone augment 112 beinginstalled, as shown in FIG. 56 .

The surgeon then holds the impaction handle 950 via the grip 960 definedin its elongated body (see FIG. 83 ) and strikes the upper surface 962of handle's metal strike plate 964 (see FIG. 83 ) with a surgicalmallet, sledge, or other impaction tool. In doing so, impaction forcesare transferred from the impact surfaces 626 of the impact shoulders622, 624 to the impact surfaces 126 of the augment's impact lugs 122,124, respectively, and also from the impact surface 632 of the impactlip 630 to the flat, inferior-facing surface 146 of the augment's boxcutout 120 thereby driving the femoral cone augment 112 into the bonetissue of the surgically-prepared cavity 322 formed in the distal end302 of the patient's femur 300.

Once the surgeon has implanted the femoral cone augment 112, the surgeonmay then implant a revision femoral prosthesis by installing its stemcomponent through the femoral cone augment and thereafter cementing itin place within the bone.

It should be appreciated that during such a procedure to implant thefemoral cone augment 112, the surgeon may elect to use one or more ofthe femoral cone trial components 512 as part of an intraoperativetrialing procedure. As shown in FIGS. 57-59 , the impactor head 600 mayalso be used to install the femoral cone trial component 512.Specifically, in a similar manner to as described above in regard toimplantation of the femoral cone augment 112, the surgeon may utilizethe impaction handle 950 to advance the distal end of the impactor head600 into the bore 518 of the femoral cone trial component 512 once thetrial component has been positioned in surgically-prepared cavity 322formed into the distal end 302 of the patient's femur 300. As theimpactor head 600 is advanced into the trial component's bore 518, thetrial component's impact lugs 522, 524 are captured in the impactorhead's guide slots 628. Specifically, the medial impact lug 522 iscaptured in the guide slot 628 on the medial side of the impactor head600 and the lateral impact lug 524 is captured in the guide slot 628 onthe lateral side of the impactor head 600. The surgeon advances theimpactor head 600 to a seated position in which the impact surfaces 626of the impact shoulders 622, 624 are positioned in contact with theimpact surfaces 526 of the trial component's impact lugs 522, 524,respectively, as shown in FIG. 58 . Doing so also positions the impactsurface 632 of the impact lip 630 into contact with the flat,inferior-facing surface 546 of the box cutout 520 of the femoral conetrial component 512 being installed, as shown in FIG. 59 .

The surgeon then holds the impaction handle 950 via the grip 960 definedin its elongated body (see FIG. 83 ) and strikes the upper surface 962of handle's metal strike plate 964 (see FIG. 83 ) with a surgicalmallet, sledge, or other impaction tool. In doing so, impaction forcesare transferred from the impact surfaces 626 of the impact shoulders622, 624 to the impact surfaces 526 of the trial component's impact lugs522, 524, respectively, and also from the impact surface 632 of theimpact lip 630 to the flat, inferior-facing surface 546 of the trialcomponent's box cutout 520 thereby driving the femoral cone trialcomponent 512 into the bone tissue of the surgically-prepared cavity 322formed in the distal end 302 of the patient's femur 300.

Once the femoral cone trial component 512 has been installed in such amanner, the surgeon may use it along with other trial components in theperformance of an intraoperative trialing procedure. Once the surgeon issatisfied with the outcome of the trialing procedure, the femoral conetrial component 512 is removed from the patient's femur 300 (in a mannerdiscussed below) and the femoral cone augment 112 is implanted in themanner described above.

It should also be appreciated that other types of augments and trialcomponents may also be embodied with impaction lugs and used incombination with an impactor head having corresponding impactionshoulders. In particular, although the concepts of FIGS. 42-59 haveherein been described in the context of a femoral cone augment 112 (andassociated trial component 512), the concepts of FIGS. 42-49 could alsobe incorporated into a bi-lobe or tri-lobe tibial cone augment (andassociated trial components) or a concentric cone augment (andassociated trial component) for use on either the tibia or the femur ofthe patient's knee.

Referring now to FIGS. 60-62 , the orthopaedic joint replacement system10 also includes a concentric cone augment 650 configured forimplantation into either the surgically-prepared cavity 222 in theproximal end 202 of the patient's tibia 200 or the surgically-preparedcavity 322 formed in the distal end 302 of the patient's femur 300. Theconcentric cone augment 650 includes an elongated conically-shapedhollow body 656 that tapers downwardly from its proximal end 652 to itsdistal end 654. The bore 658 defined by the hollow body 656 is sized andshaped to receive a tibial stem component of a tibial revisionprosthesis (not shown) when the concentric cone augment is implanted inthe proximal end 202 of the patient's tibia 200 or a femoral stemcomponent of a femoral revision prosthesis (not shown) when theconcentric cone augment is implanted in the distal end 302 of thepatient's femur 300. Moreover, the body 656 has a pair of cutouts 660formed in the proximal end 652 of the concentric cone augment 650. Thecutouts 660 provide clearance for the keels of a revision tibial tray orthe box of a revision femoral component.

As can be seen in FIGS. 60 and 61 , the proximal end 652 of theconcentric cone augment's hollow body 656 defines an annular rim 668that extends radially between the body's inner sidewall 662 and itsouter sidewall 664. Given the presence of the cutouts 660, the annularrim 668 has an interrupted surface.

Like the bodies of the tibial cone component 12 and the femoral coneaugment 112, the body 656 of the concentric cone augment 650 isillustratively embodied as a solid-metal base 672 having a porous-metalcoating 670 disposed thereon. The solid-metal base 672 and theporous-metal coating 670 may be embodied and manufactured in a similarmanner as to the solid-metal base 32 and the porous metal coating 30discussed above in regard to the tibial cone component 12, with all suchfeatures, methods, starting materials, and alternatives not beingrepeated herein for purposes of brevity. In the illustrative embodimentdescribed herein, like as was described above in regard to the tibialcone augment 12, the porous-metal coating 670 is disposed on thesolid-metal base 672 of the concentric cone augment 650 by virtue ofbeing additively manufactured contemporaneously with the solid-metalbase 672 so as to create a common, monolithic component of the two metalstructures.

As can be seen in FIGS. 60 and 62 , the inner sidewall 662 that definesthe bore 658 of the hollow body 656 has a number of cement pockets 674formed therein. Bone cement is received into the cement pockets 674 toincrease adhesion of the cement to the concentric cone augment 650during implantation of the tibial revision prosthesis or the femoralrevision prosthesis.

Like the tibial cone augment 12 and femoral cone augment 112, theconcentric cone augment 650 may be provided in a number of differentconfigurations to fit the needs of a given patient's anatomy. Inparticular, the concentric cone augment 650 may be configured in variousdifferent sizes to conform to the patient's anatomy and/or accommodate awide range of bone loss. In one illustrative embodiment, the concentriccone augment 650 may be provided in four different sizes (e.g., SizesSmall (S), Medium (M), Large (L), Extra Large (XL)), although othersizes (e.g., Size Double Extra Large (XXL)) could also be provided tofit the needs of a given design of the orthopaedic joint replacementsystem 10. The inner diameter of the annular rim 668 of the hollow body656 changes as a function of the size of the concentric cone augment650. Specifically, the inner diameter (ID_(AUG)) of the augment'sannular rim 668 increases as the size of the concentric cone augment 650increases. In other words, the annular rim 658 of a Size M concentriccone augment 650 has a larger inner diameter (ID_(AUG)) than the annularrim 658 of a Size S concentric cone augment 650, but a smaller innerdiameter (ID_(AUG)) than the annular rim 658 of a Size L (or Size XL)concentric cone augment 650.

Referring now to FIGS. 63-65 , there is shown another knee cone trialcomponent 700, specifically a concentric cone trial component 702. Asused herein, the term “concentric cone trial component” refers to a kneecone trial component that is sized and shaped to mimic a concentric coneaugment such as the concentric cone augment 650.

Because the concentric cone trial component 702 is designed to mimic theconcentric cone augment 650, it possesses a similar structure as theaugment 650. Specifically, as can be seen in FIGS. 63-65 , theconcentric cone trial component 702 includes an elongatedconically-shaped hollow body 716 that tapers downwardly from itsproximal end 712 to its distal end 714. The bore 718 defined by thehollow body 716 is sized and shaped to receive a tibial stem trialcomponent of a tibial revision trial prosthesis (not shown) when theconcentric cone trial component 702 is installed in the proximal end 202of the patient's tibia 200 or a femoral stem trial component of afemoral revision trial prosthesis (not shown) when the concentric conetrial component 702 is installed in the distal end 302 of the patient'sfemur 300. Moreover, the trial component's body 716 has a pair ofcutouts 720 formed in the proximal end 712 of the concentric cone trialcomponent 702. The cutouts 720 provide clearance for the keels of arevision tibial tray trial component or the box of a revision femoraltrial component.

As can be seen in FIGS. 63 and 64 , the proximal end 712 of the trialcomponent's hollow body 716 defines an annular rim 728 that extendsradially between the body's inner sidewall 722 and its outer sidewall724. Given the presence of the cutouts 720, the annular rim 668 has aninterrupted surface.

The concentric cone trial component 700 may be provided in a number ofdifferent configurations to correspond to the different configurationsof the concentric cone augment 650. In particular, the concentric conetrial component 700 may be configured in various different sizes toconform to the range of sizes of the concentric cone augments 650. Inone illustrative embodiment, the concentric cone trial component 700 maybe provided in four different sizes (e.g., Sizes Small (S), Medium (M),Large (L), Extra Large (XL)), although other sizes (e.g., Size DoubleExtra Large (XXL)) could also be provided if such additional sizes ofthe concentric cone augment 650 is also provided. Like the augment itmimics, the inner diameter of the annular rim 728 of the hollow body 716changes as a function of the size of the concentric cone trial component700. Specifically, the inner diameter (IDT_(TRI)) of the trialcomponent's annular rim 728 increases as the size of the concentric conetrial component 700 increases. In other words, the annular rim 728 of aSize M concentric cone trial component 700 has a larger inner diameter(ID_(TRI)) than the annular rim 728 of a Size S concentric cone trialcomponent 700, but a smaller inner diameter (ID_(TRI)) than the annularrim 728 of a Size L (or Size XL) concentric cone trial component 700.

Referring now to FIGS. 66-69 , there is shown an impactor head 800 thatis configured to impact the concentric cone augment 650 and theconcentric cone trial component 700 during installation of the augment650 and the trial component 700 into the patient's knee. Similarly tothe impactor head 600 described above, a proximal surface 804 of thebody 802 of the impactor head 800 is configured to be secured to aremovable impaction handle. In the illustrative embodiment describedherein, the proximal surface 804 includes a connector 806 for connectingthe impactor head 800 to the impaction handle 950 (see FIG. 83 ). Itshould be appreciated; however, that in other embodiments the proximalsurface 804 may also be secured to an integrated, non-removableimpaction handle. The connector 806 includes a D-shaped socket 808formed in the proximal surface 804 of the impactor head 800. TheD-shaped socket 808 is sized, shaped, and positioned to receive theD-shaped connecting pin 952 of the connector 954 of the impaction handle950 (see FIG. 83 ). The connector 806 of the impactor head 800 alsoincludes a connector lip 810. When the impaction handle's connecting pin952 is inserted in the D-shaped socket 808 of the impactor head 800 andthereafter advanced downwardly, the connector lip 810 is engaged by alocking pawl 956 of the impaction handle's connector 954 (see FIGS. 70and 71 ) to secure the impactor head 800 to the impaction handle 950.

Opposite the proximal surface 804, the body 802 of the impactor head 800includes an impact surface 816. The impact surface 816 has a number ofannular-shaped concentric flanges 818 formed therein. In theillustrative embodiment described herein, the concentric flanges 818include a lead-in flange 820 and a pair of impact flanges 822, 824. Ascan be seen in FIGS. 67-69 , the diameter (D_(F1)) of the lead-in flange820 is smaller than the diameter (D_(F2)) of the impact flange 822 andthe diameter (D_(F3)) of the impact flange 824. In addition, thediameter (D_(F2)) of the impact flange 822 is smaller than the diameter(D_(F3)) of the impact flange 824. Such a terraced surface design allowsthe impactor head 800 to be used in the installation of differentlysized concentric cone augments 650 and concentric cone trial components700 thereby eliminating the need to have an impactor head for each sizeof augments and trial components.

For instance, the impactor head 800 may be used to install both a Size Lconcentric cone augment 650 (as shown in FIG. 72 ) and a Size XLconcentric cone augment 650 (as shown in FIG. 73 ). As can be seen inFIG. 72 , when used to install the smaller of two sizes of theconcentric cone augment 650 (for example a Size L augment versus a SizeXL augment), the diameter (D_(F1)) of the lead-in flange 820 is smallerthan the inner diameter (ID_(AUG)) of the augment's annular rim 668thereby allowing the lead-in flange 820 to be advanced into theaugment's bore 658. However, both the diameter (D_(F2)) of the impactflange 822 and the diameter (D_(F3)) of the impact flange 824 are largerthan the inner diameter (ID_(AUG)) of the augment's annular rim 668. Assuch, the impact flange 822 rests on top of the augment's annular rim668 when the lead-in flange 820 of the impactor head 800 is positionedin the augment's bore 658 thereby allowing impaction forces totransferred from the impact flange 822 to the augment's annular rim 668during installation of the augment. As can be seen in FIG. 73 , whenused to install the larger of two sizes of the concentric cone augment650 (for example a Size XL augment versus a Size L augment), both thediameter (D_(F1)) of the lead-in flange 820 and the diameter (D_(F2)) ofthe impact flange 822 are smaller than the inner diameter (ID_(AUG)) ofthe augment's annular rim 668 thereby allowing both the lead-in flange820 and the impact flange 822 to be advanced into the augment's bore658. However, the diameter (D_(F3)) of the impact flange 824 is largerthan the inner diameter (ID_(AUG)) of the augment's annular rim 668. Assuch, the impact flange 824 rests on top of the augment's annular rim668 when the lead-in flange 820 and the impact flange 822 of theimpactor head 800 are positioned in the augment's bore 658 therebyallowing impaction forces to transferred from the impact flange 824 tothe augment's annular rim 668 during installation of the augment.

As shown in FIGS. 74 and 75 , the impactor head 800 may also be used inthe installation of two differently sized concentric cone trialcomponents 700 in a similar manner. In particular, as can be seen inFIG. 74 , when used to install the smaller of two sizes of theconcentric cone trial component 700 (for example a Size L trialcomponent versus a Size XL trial component), the diameter (D_(F1)) ofthe lead-in flange 820 is smaller than the inner diameter (ID_(TRI)) ofthe trial component's annular rim 728 thereby allowing the lead-inflange 820 to be advanced into the trial component's bore 718. However,both the diameter (D_(F2)) of the impact flange 822 and the diameter(D_(F3)) of the impact flange 824 are larger than the inner diameter(ID_(TRI)) of the trial component's annular rim 728. As such, the impactflange 822 rests on top of the trial component's annular rim 728 whenthe lead-in flange 820 of the impactor head 800 is positioned in thetrial component's bore 718 thereby allowing impaction forces totransferred from the impact flange 822 to the trial component's annularrim 728 during installation of the trial component. As can be seen inFIG. 75 , when used to install the larger of two sizes of the concentriccone trial component 700 (for example a Size XL trial component versus aSize L trial component), both the diameter (D_(F1)) of the lead-inflange 820 and the diameter (D_(F2)) of the impact flange 822 aresmaller than the inner diameter (ID_(TR)) of the trial component'sannular rim 728 thereby allowing both the lead-in flange 820 and theimpact flange 822 to be advanced into the trial component's bore 718.However, the diameter (D_(F3)) of the impact flange 824 is larger thanthe inner diameter (ID_(TRI)) of the trial component's annular rim 728.As such, the impact flange 824 rests on top of the trial component'sannular rim 728 when the lead-in flange 820 and the impact flange 822 ofthe impactor head 800 are positioned in the trial component's bore 718thereby allowing impaction forces to transferred from the impact flange824 to the trial component's annular rim 728 during installation of thetrial component.

It should be appreciated that although the relationship of the impactorhead 800 and the concentric cone augment 650 and the concentric conetrial component 700 has been illustratively described in regard to SizeL and Size XL augments and trial components, it should be appreciatedthat the impactor head 800 may be configured for use with other sizes.For example, a single impactor head 800 may be designed for use withSize S and Size M augments and trial components. Moreover, by addingadditional impact flanges (beyond the impact flanges 822, 824), theimpactor head 800 may be used with more than two sizes of augments andtrial components. For example, the impactor head 800 may be configuredwith three impact flanges thereby allowing it to be used in theinstallation of three different sizes of the augments and trialcomponents.

Like the other orthopaedic surgical instruments discussed above, in theillustrative embodiment described herein, the impactor head 800 isconstructed with stainless steel. Other suitable materials may be usedto fit the needs of a given design of the impactor head 800.

As can be seen in FIGS. 70 and 71 , the impactor head 800 may be usedduring installation of the concentric cone augment 650 in a revisionprocedure in which a primary tibial implant has been removed from theproximal end 202 of the patient's tibia 200 (FIG. 70 ) or in which aprimary femoral implant has been removed from the distal end 302 of thepatient's femur 300 (FIG. 71 ). The impactor head 800 may also be usedto install the concentric cone trial component 700 during such arevision procedure. Prior to installation of either the concentric coneaugment 650 or the concentric cone trial component 700, the cavity 222to receive the concentric cone augment 650 (or trial component 700) isfirst surgically-prepared in the proximal end 202 of the patient's tibia200 (FIG. 70 ) or the cavity 322 to receive the concentric cone augment650 (or trial component 700) is first surgically-prepared in the distalend 302 of the patient's femur 300. The method described above in regardto FIGS. 25-31 may be used as a procedure for surgically-preparing thecavity 222 in the proximal end 202 of the patient's tibia 200 and themethod described above in regard to FIGS. 32-36 may be used as aprocedure for surgically-preparing the cavity 322 in the distal end 302of the patient's femur 300. However, it should be appreciated that suchsurgical procedures may include additional, fewer, or alternate stepsdepending on the state of the patient's bony anatomy and the preferencesof the surgeon.

Once the surgically-prepared cavity 222 or the surgically-preparedcavity 322 has been formed in the patient's bone, the surgeon positionsa concentric cone augment 650 of the appropriate size in the cavity.Thereafter, the surgeon utilizes the impactor head 800 to impact theconcentric cone augment 650. To do so, the surgeon first connects animpactor head 800 to the impaction handle 950. To do so, the impactionhandle's connecting pin 952 (see FIG. 83 ) is inserted in the D-shapedsocket 808 of the impactor head 800 and thereafter advanced downwardly.The connector lip 810 of the impactor head 800 is then engaged by thelocking pawl 956 of the impaction handle's connector 954 to secure theimpactor head 800 to the impaction handle 950.

The surgeon then utilizes the impaction handle 950 to advance the distalend of the impactor head 800 into the bore 658 of the concentric coneaugment 650 positioned in the patient's bone. In doing so, the lead-inflange 820 of the impactor head 800 is advanced into the concentric coneaugment's bore 658. Depending on the size of the concentric cone augment650 being installed, the impact flange 822 either comes to rest on theaugment's annular rim 668 or is also advanced with the lead-in flange820 into the augment's bore 658 (in the case of a larger augment) inwhich case the impact flange 824 comes to rest on the augment's annularrim 668. In either case, once the impactor head 800 is seated, one ofthe impact flanges 822, 824 is positioned in contact with the augment'sannular rim 668.

The surgeon then holds the impaction handle 950 via the grip 960 definedin its elongated body (see FIG. 83 ) and strikes the upper surface 962of handle's metal strike plate 964 (see FIG. 83 ) with a surgicalmallet, sledge, or other impaction tool. In doing so, impaction forcesare transferred from the impact flange 822 or the impact flange 824(depending which one is in contact with the augment's annular rim 668based on the size of the augment) to the augment's annular rim 668thereby driving the concentric cone augment 650 into the bone tissue.

Once the surgeon has implanted the concentric cone augment 650, thesurgeon may then implant a revision prosthesis by installing its stemcomponent through the concentric cone augment 650 and thereaftercementing it in place within the bone.

It should be appreciated that during such a procedure to implant theconcentric cone augment 650, the surgeon may elect to use one or more ofthe concentric cone trial components 700 as part of an intraoperativetrialing procedure. As shown in FIGS. 74 and 75 and discussed above, theimpactor head 800 may also be used to install the concentric cone trialcomponent 700. Specifically, in a similar manner to as described abovein regard to implantation of the concentric cone augment 650, thesurgeon may utilize the impaction handle 950 to advance the distal endof the impactor head 800 into the bore 718 of the concentric cone trialcomponent 700 once the trial component has been positioned in thesurgically-prepared cavity formed in the patient's bone. As the impactorhead 800 is advanced into the trial component's bore 718, the lead-inflange 820 of the impactor head 800 is advanced into the concentric conetrial component's bore 718. Depending on the size of the concentric conetrial component 700 being installed, the impact flange 822 either comesto rest on the trial component's annular rim 728 or is also advancedwith the lead-in flange 820 into the trial component's bore 718 (in thecase of a larger trial component) in which case the impact flange 824comes to rest on the trial component's annular rim 728. In either case,once the impactor head 800 is seated, one of the impact flanges 822, 824is positioned in contact with the trial component's annular rim 728.

The surgeon then holds the impaction handle 950 via the grip 960 definedin its elongated body (see FIG. 83 ) and strikes the upper surface 962of handle's metal strike plate 964 (see FIG. 83 ) with a surgicalmallet, sledge, or other impaction tool. In doing so, impaction forcesare transferred from the impact flange 822 or the impact flange 824(depending which one is in contact with the trial component's annularrim 728 based on the size of the trial component) to the trialcomponent's annular rim 728 thereby driving the concentric cone trialcomponent 700 into the bone tissue.

Once the concentric cone trial component 700 has been installed in sucha manner, the surgeon may use it along with other trial components inthe performance of an intraoperative trialing procedure. Once thesurgeon is satisfied with the outcome of the trialing procedure, theconcentric cone trial component 700 is removed from the patient's knee(in a manner discussed below) and the concentric cone augment 650implanted in the manner described above.

It should also be appreciated that other types of augments and trialcomponents may also be embodied used in combination with an impactorhead having corresponding concentric impaction flanges. In particular,although the concepts of FIGS. 60-75 have herein been described in thecontext of a concentric cone augment 650 (and associated trial component700), the concepts of FIGS. 60-75 could also be incorporated into abi-lobe or tri-lobe tibial cone augment (and associated trialcomponents) or a femoral cone augment (and associated trial components).

Referring now to FIGS. 76-78 , there is shown another orthopaedicsurgical instrument of the orthopaedic joint replacement system 10.Specifically, there is shown a trial extractor 850 that is operable toextract knee cone trial components from the knee of a patient subsequentto use of the trial components in an intraoperative trialing procedure.For example, the trial extractor 850 may be used to extract the femoralcone trial component 512 (see FIGS. 46-49 ) from the surgically-preparedcavity 322 formed in the distal end 302 of the patient's femur 300. Thetrial extractor 850 may also be used to extract a tibial cone trialcomponent 912 (see FIGS. 80-82 ) from the surgically-prepared cavity 222formed in the proximal end 202 of the patient's tibia 200. Likewise, thetrial extractor 850 may be used to extract the concentric cone trialcomponent 700 (see FIGS. 63-65 ) from either surgically-prepared cavity222, 322.

The trial extractor 850 includes a connector body 852 that is configuredto be secured to a removable impaction handle. In the illustrativeembodiment described herein, the connector body 852 includes a connector856 for connecting the trial extractor 850 to the impaction handle 950(see FIG. 83 ). It should be appreciated; however, that in otherembodiments the connector body 852 may also be secured to an integrated,non-removable impaction handle. The connector 856 includes a D-shapedsocket 858 formed in the proximal surface 854 of the trial extractor850. The D-shaped socket 858 is sized, shaped, and positioned to receivethe D-shaped connecting pin 952 of the connector 954 of the impactionhandle 950 (see FIG. 83 ). The connector 856 of the trial extractor 850also includes a connector lip 860. When the impaction handle'sconnecting pin 952 is inserted in the D-shaped socket 858 of the trialextractor 850 and thereafter advanced downwardly, the connector lip 860is engaged by a locking pawl 956 of the impaction handle's connector 954(see FIG. 79 ) to secure the trial extractor 850 to the impaction handle950.

The trial extractor 850 also includes a pair of extractor arms 864, 866.The extractor arms 864, 866 are pivotally coupled to the connector body852 by a pivot pin 868. Specifically, as can be seen in FIG. 76 , theconnector body 852 is a generally U-shaped structure defined in part bypair of mounting flanges 870 that are spaced apart from one another.Each of the mounting flanges 870 has an aperture 872 defined therein.Likewise, the proximal end 874 of each of the extractor arms 864, 866has an aperture 876 defined therein. The pivot pin 868 is positioned inthe apertures 872 of the connector body's mounting flanges 870 and theapertures 876 of the extractor arms 864, 866 so as to pivotally couplethe arms 864, 866 to the mounting flanges 870.

As can be seen in FIG. 76 , the trial extractor 850 also includes aspring 878 that asserts a spring bias on the extractor arms 864, 866 soas to urge the arms 864, 866 away from one another. In the illustrativeembodiment described herein, the spring 878 is embodied as a torsionspring having a loop 880 with a pair of spring arms 882 extending awayfrom the loop 880. As can be seen in FIG. 76 , the pivot pin 868 extendsthrough the loop 880 of the torsion spring 878 so as to capture thespring. One of the spring's arms 882 is biased against the extractor arm864, with the other spring arm 882 being biased the extractor arm 866.In such a way, the spring arms 882 urge the extractor arms 864, 866 awayfrom one another.

Each of the extractor arms 864, 866 has a prong 884 formed in its distalend 886. The prongs 884 are sized and shaped to be received into anextraction opening 888 formed in a knee cone trial component such as thefemoral cone trial component 512 (see FIGS. 46-49 ), the tibial conetrial component 912 (see FIGS. 80-82 ), and the concentric cone trialcomponent 700 (see FIGS. 63-65 ). In the illustrative embodimentdescribed herein, each of the extraction openings 888 is diamond shaped,with each of the prongs 884 defining a pointed tip 890 (see FIG. 78 )which is received into the diamond shaped extraction openings 888 of thetrial components. However, it should be appreciated that the extractionopenings 888 and the corresponding pointed tips 890 of the prongs 884may have other shapes to fit the needs of a given instrument design.

Each of the trial components includes at least one pair of theextraction openings 888 positioned on opposite sides of the trialcomponent from one another so as to accommodate the prongs 884 formed onthe extractor arms 864, 866. For example, as shown in FIGS. 46-49 , thefemoral cone trial component 512 includes a pair of extraction openings888 that extend between the inner sidewall 536 of the trial componentand its outer sidewall 538, with one of such extraction openings 888being positioned on the medial side of the trial component's hollow body516 and the other extraction opening 888 being positioned on itsopposite, lateral side. Further, as shown in 80-82, the tibial conetrial component 912 includes two pairs of extraction openings 888. Ascan be seen best in FIGS. 80 and 81 , each of the extraction openings888 extends between the inner sidewall 936 of the trial component andits outer sidewall 938. As can be seen best in FIG. 81 , one pair of theextraction openings 888 is positioned on the medial and lateral sides ofthe tibial cone trial component 912, with the other pair beingpositioned on the anterior and posterior sides of the trial component.As shown in FIGS. 63-65 , the concentric cone trial component 700 hasmultiple pairs of extraction openings 888 formed therein, with each ofsuch extraction openings extending between the inner sidewall 722 andthe outer sidewall 724 of the trial component's hollow body 716. As canbe seen best in FIG. 64 , one pair of the extraction openings 888 ispositioned on the medial and lateral sides of the trial component 700,with the other pair being positioned on the anterior and posterior sidesof the trial component.

Referring now to FIG. 79 , use of the trial extractor 850 will beillustratively described in the context of the removal of the concentriccone trial component 700 from the distal end 302 of the patient's femur300 in a revision procedure in which a primary femoral implant has beenpreviously removed from the patient's femur 300. However, it should beappreciated that the trial extractor 850 may be used in a similar mannerto as described in regard to FIG. 79 to remove the concentric cone trialcomponent 700 from the proximal end 202 of the patient's tibia 200. Thetrial extractor 850 may also be used in a similar manner to as describedin regard to FIG. 79 to remove the femoral trial component 512 from thedistal end 302 of the patient's femur 300 or the tibial cone trialcomponent 912 from the proximal end 202 of the patient's tibia 200.

The cavity 322 to receive the concentric cone trial component 700 isfirst surgically-prepared in the distal end 302 of the patient's femur300. The method described above in regard to FIGS. 32-36 may be used asa procedure for surgically-preparing the distal end 302 of the patient'sfemur 300 in such a manner. However, it should be appreciated that sucha surgical procedure may include additional, fewer, or alternate stepsdepending on the state of the patient's bony anatomy and the preferencesof the surgeon.

Once the surgically-prepared cavity 322 has been formed in the distalend 302 of the patient's femur 300, the surgeon positions and installs aconcentric cone trial component 700 of the appropriate size in thecavity 322. The surgeon may utilize the impactor head 800 to impact theconcentric cone trial component 700 during such installation or may optfor additional, fewer, or alternate steps in installing the trialcomponent 700 depending on the state of the patient's bony anatomy andthe preferences of the surgeon.

Once the concentric cone trial component 700 has been installed in thepatient's femur 300, the surgeon may use it along with other trialcomponents in the performance of an intraoperative trialing procedure.In doing so, the surgeon moves the patient's knee through a trial rangeof motion to assess the fit and alignment of the installed trialcomponents.

Once the surgeon is satisfied with the outcome of the trialingprocedure, the concentric cone trial component 700 is removed from thepatient's femur 300 by use of the trial extractor 850. To do so, thesurgeon first connects the trial extractor 850 to the impaction handle950. Specifically, the impaction handle's connecting pin 952 (see FIG.83 ) is inserted in the D-shaped socket 858 of the trial extractor 850and thereafter advanced downwardly such that the connector lip 860 ofthe trial extractor 850 is engaged by the locking pawl 956 of theimpaction handle's connector 954 to secure the trial extractor 850 tothe impaction handle 950.

The surgeon then utilizes the impaction handle 950 to advance the distalends 886 of the instrument's extractor arms 864, 866 into the bore 718of the concentric cone trial component 700 installed in the distal end302 of the patient's femur 300. During such advancement, the surgeonsqueezes the extractor arms 864, 866 to overcome the spring bias of thetorsion spring 878 thereby urging the prongs 884 toward one another soas to allow the prongs 884 to clear the trial component's annular rim728 and enter its bore 718. Once the prongs 884 are positioned in thetrial component's bore 718, the surgeon aligns them with one of thepairs of extraction openings 888. In the illustrative embodiment of FIG.79 , the surgeon has aligned the prongs 884 with the extraction openings888 on the medial and lateral sides of the trial component 700, althoughthe pair of extraction openings 888 positioned on the anterior andposterior sides of the trial component 700 may also be used in lieuthereof.

Once the prongs 884 have been aligned with the desired pair ofextraction openings 888, the surgeon gently releases the extractor arms864, 866 thereby allowing the spring bias of the torsion spring 878 tourge the prongs 884 away from one another and into the extractionopenings 888. Specifically, in the illustrative example of FIG. 79 , oneof the prongs 884 is captured in the extraction opening 888 on themedial side of the concentric cone trial component 700 and the otherprong 884 is captured in the extraction opening 888 on the lateral sideof the trial component 700.

The surgeon then holds the impaction handle 950 via the grip 960 definedin its elongated body (see FIG. 83 ) and strikes the lower surface 966of handle's metal strike plate 964 (see FIG. 83 ) with a surgicalmallet, sledge, or other impaction tool. In doing so, extraction forcesare transferred from the extractor arms 864, 866 of the trial extractor850 to the concentric cone trial component 700 thereby urging the trialcomponent 700 out of the bone tissue of the surgically-prepared cavity322 formed in the distal end 302 of the patient's femur 300.

Once the concentric cone trial component 700 is removed from thepatient's femur 300, the surgeon may then install the concentric coneaugment 650 in its place in the manner described above and thereafterimplant a revision femoral prosthesis by installing its stem componentthrough the concentric cone augment 650 and thereafter cementing it inplace within the bone.

While the disclosure has been illustrated and described in detail in thedrawings and foregoing description, such an illustration and descriptionis to be considered as exemplary and not restrictive in character, itbeing understood that only illustrative embodiments have been shown anddescribed and that all changes and modifications that come within thespirit of the disclosure are desired to be protected.

There are a plurality of advantages of the present disclosure arisingfrom the various features of the apparatus, system, and method describedherein. It will be noted that alternative embodiments of the apparatus,system, and method of the present disclosure may not include all of thefeatures described yet still benefit from at least some of theadvantages of such features. Those of ordinary skill in the art mayreadily devise their own implementations of the apparatus, system, andmethod that incorporate one or more of the features of the presentinvention and fall within the spirit and scope of the presentdisclosure.

1. An orthopaedic knee implant, comprising: a knee cone augmentconfigured to be implanted into a surgically-prepared cavity in an endof a bone of a patient's knee, the knee cone augment comprising: a roundelongated body having a superior end and an inferior end, a boreconfigured to receive a stem of a revision knee prosthesis extendingthrough the elongated body, the bore being defined by a conically-shapedinner sidewall extending through the elongated body between its superiorend and its inferior end, and a number of impact lugs secured to theinner sidewall at a location between the superior end and the inferiorend of the elongated body, wherein each of the number of impact lugs (i)extends inwardly from the inner sidewall toward a central axis of thebore, and (ii) has a flat, inferior-most impact surface.
 2. Theorthopaedic knee implant of claim 1, wherein the knee cone augmentcomprises a femoral cone augment configured to be implanted into asurgically-prepared cavity in a distal end of a femur of the patient'sknee.
 3. The orthopaedic knee implant of claim 1, wherein each of thenumber of impact lugs includes a curved outer body extending superiorlyfrom the impact surface.
 4. The orthopaedic knee implant of claim 3,wherein the curved outer body of each of the number of impact lugs istapered in the superior/inferior direction such that a superior endthereof blends into the inner sidewall.
 5. The orthopaedic knee implantof claim 1, wherein the number of impact lugs includes a medial impactlug secured to a medial side of the inner sidewall and a lateral impactlug secured to a lateral side of the inner sidewall.
 6. The orthopaedicknee implant of claim 1, wherein: the knee cone augment comprises afemoral cone augment configured to be implanted into asurgically-prepared cavity in a distal end of a femur of the patient'sknee, the femoral cone augment has box cutout formed in a posterior sidethereof, the box cutout is configured to receive a box of a revisionfemoral prosthesis, the box cutout is defined in part by a flat,inferior-facing surface, and the impact surface of each of the number ofimpact lugs is coplanar with the flat, inferior-facing surface of thebox cutout.
 7. The orthopaedic knee implant of claim 1, wherein theimpact surfaces of each of the number of impact lugs are coplanar withone another.
 8. The orthopaedic knee implant of claim 1, wherein theinner sidewall has a number cement pockets formed therein.
 9. Anorthopaedic knee implant, comprising: a femoral cone augment configuredto be implanted into a surgically-prepared cavity in a distal end of afemur of a patient's knee, the femoral cone augment comprising: a roundelongated body having a superior end and an inferior end, a boreconfigured to receive a stem of a revision femoral prosthesis extendingthrough the elongated body, the bore being defined by a conically-shapedinner sidewall extending through the elongated body between its superiorend and its inferior end, a pair of impact lugs secured to the innersidewall at a location between the superior end and the inferior end ofthe elongated body, wherein both of the pair of impact lugs (i) extendinwardly from the inner sidewall toward a central axis of the bore, and(ii) have a flat, inferior-most impact surface.
 10. The orthopaedic kneeimplant of claim 9, wherein both of the pair of impact lugs include acurved outer body extending superiorly from the impact surface.
 11. Theorthopaedic knee implant of claim 10, wherein the curved outer body ofboth of the pair of impact lugs is tapered in the superior/inferiordirection such that a superior end thereof blends into the innersidewall.
 12. The orthopaedic knee implant of claim 9, wherein the pairof impact lugs includes a medial impact lug secured to a medial side ofthe inner sidewall and a lateral impact lug secured to a lateral side ofthe inner sidewall.
 13. The orthopaedic knee implant of claim 9,wherein: the femoral cone augment has box cutout formed in a posteriorside thereof, the box cutout is configured to receive a box of therevision femoral prosthesis, the box cutout is defined in part by aflat, inferior-facing surface, and the impact surface of both of thepair of impact lugs is coplanar with the flat, inferior-facing surfaceof the box cutout.
 14. The orthopaedic knee implant of claim 9, whereinthe impact surface of each of the number of impact lugs is coplanar withone another.
 15. The orthopaedic knee implant of claim 9, wherein theinner sidewall has a number cement pockets formed therein.
 16. Anorthopaedic knee system, comprising: a knee cone augment configured tobe implanted into a surgically-prepared cavity in an end of a bone of apatient's knee, the knee cone augment comprising (i) a round elongatedbody having a superior end and an inferior end, (ii) a bore configuredto receive a stem of a revision knee prosthesis extending through theelongated body, the bore being defined by a conically-shaped innersidewall extending through the elongated body between its superior endand its inferior end, and (iii) a number of impact lugs secured to theinner sidewall at a location between the superior end and the inferiorend of the elongated body, wherein each of the number of impact lugs hasa flat impact surface, and an impactor head configured to impact theknee cone augment during a surgical procedure to implant the knee coneaugment, the impactor head comprising (i) a proximal surface configuredto be secured to an impaction handle, and (ii) an impact surfaceopposite the proximal surface, the impact surface having a number ofimpact shoulders formed therein, wherein each of the number of impactshoulders has a flat impact surface that is sized and shaped to bepositioned on the impact surface of one of the number of impact lugs ofthe knee cone augment when the impactor head is used to impact the kneecone augment.
 17. The orthopaedic knee system of claim 16, wherein theknee cone augment comprises a femoral cone augment configured to beimplanted into a surgically-prepared cavity in a distal end of a femurof the patient's knee.
 18. The orthopaedic knee system of claim 16,wherein: each of the number of impact lugs includes a curved outer bodyextending away from the impact surface of the impact lug, the impactorhead has a number of guide slots formed therein, each of the impactshoulders define a proximal end of one of the number of guide slots, andeach of the number of impact lugs of the knee cone implant is receivedinto one of the number of guide slots of the impactor head when theimpactor head is used to impact the knee cone augment.
 19. Theorthopaedic knee system of claim 16, wherein: the number of impact lugsincludes a medial impact lug secured to a medial side of the innersidewall and a lateral impact lug secured to a lateral side of the innersidewall, and the number of impact shoulders includes a medial impactshoulder formed in a medial side of the impactor head and a lateralimpact shoulder formed in a lateral side of the impactor head.
 20. Theorthopaedic knee system of claim 16, wherein: the knee cone augmentcomprises a femoral cone augment configured to be implanted into asurgically-prepared cavity in a distal end of a femur of the patient'sknee, the femoral cone augment has box cutout formed in a posterior sidethereof, the box cutout is configured to receive a box of a revisionfemoral prosthesis, the box cutout is defined in part by a flat,inferior-facing surface, the impact surface of the impactor head has animpact lip formed therein, and the impact lip has a flat impact surfacethat is sized and shaped to be positioned on the flat, inferior-facingsurface of the box cutout when the impactor head is used to impact theknee cone augment.
 21. The orthopaedic knee system of claim 20, wherein:the impact surface of each of the number of impact lugs of the femoralcone augment is coplanar with the flat, inferior-facing surface of thebox cutout of the femoral cone augment, and the flat impact surface ofeach of the number of impact shoulders of the impactor head is coplanarwith the flat impact surface of the impact lip of the impactor head. 22.A method of surgically preparing a knee of a patient, the methodcomprising: forming a surgically-prepared cavity in an end of a bone ofthe knee of the patient, positioning a knee cone augment in the cavityformed in the end of the bone, the knee cone augment having (i) a boreformed therein, and (ii) a number of impact lugs positioned in the bore,advancing a distal end of an impactor head into the bore of knee coneaugment such that a number of impact shoulders of the impactor head arepositioned in contact with the number of impact lugs of the knee coneaugment, and impacting the impactor head such that impaction forces aretransferred from the number of impact shoulders of the impactor head tothe number of impact lugs of the knee cone augment.
 23. The method ofclaim 22, wherein: the knee cone augment comprises a femoral coneaugment configured to be implanted into a surgically-prepared cavity ina distal end of a femur of the patient's knee, the femoral cone augmenthas box cutout formed in a posterior side thereof, the box cutout is (i)configured to receive a box of a revision femoral prosthesis, and (ii)defined in part by a flat, inferior-facing surface, advancing the distalend of an impactor head into the bore of the knee cone augment comprisesadvancing the distal end of the impactor head into the bore of thefemoral cone augment such that an impact lip of the impactor head ispositioned in contact with the flat, inferior-facing surface of the boxcutout of the femoral cone augment, and impacting the impactor headincludes impacting the impactor head such that impaction forces aretransferred from the impact lip of the impactor head to the flat,inferior-facing surface of the box cutout of the femoral cone augment.24. The method of claim 22, further comprising removing apreviously-installed knee implant from the end of a bone of the knee ofthe patient prior to forming the cavity in the end of the bone of theknee of the patient.